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 $2,570.40 Median $5,495.41 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,000.00 | Professional | None | $724.44 | $724.44 | $1,000.00 |
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 $812.83 Median $1,174.90 Typical High $1,778.28 | Professional | None | $812.83 | $1,174.90 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,691.53 Typical High $3,981.07 | Facility | None | $812.83 | $2,691.53 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,230.27 | Professional | None | $660.69 | $831.76 | $1,230.27 |
Denver HMP Setting Facility Modifier None Typical Low $724.44 Median $851.14 Typical High $1,548.82 | Facility | None | $724.44 | $851.14 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,380.38 | Professional | None | $691.83 | $912.01 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $3,467.37 | Facility | None | $691.83 | $1,445.44 | $3,467.37 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,023.29 | Professional | None | $691.83 | $758.58 | $1,023.29 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $1,445.44 | Professional | None | $691.83 | $933.25 | $1,445.44 |
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 $363.08 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $512.86 |
Where Colorado sits
The same service costs 7.6 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· 12th of 51
$1,175
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.