How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,995.26 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,047.13 | Professional | None | $851.14 | $851.14 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,445.44 Typical High $2,137.96 | Professional | None | $977.24 | $1,445.44 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,344.23 Typical High $3,311.31 | Facility | None | $831.76 | $2,344.23 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,479.11 | Professional | None | $741.31 | $954.99 | $1,479.11 |
Denver HMP Setting Facility Modifier None Typical Low $794.33 Median $954.99 Typical High $1,905.46 | Facility | None | $794.33 | $954.99 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,698.24 | Professional | None | $851.14 | $1,148.15 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $2,754.23 | Facility | None | $851.14 | $1,698.24 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $1,288.25 | Professional | None | $851.14 | $891.25 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,698.24 | Professional | None | $724.44 | $1,000.00 | $1,698.24 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $602.56 |
Where Colorado sits
The same service costs 7.2 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Colorado· 13th of 51
$1,413
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.