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 $977.24 Median $977.24 Typical High $1,230.27 | Professional | None | $977.24 | $977.24 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $15,135.61 Typical High $25,703.96 | Facility | None | $10,000.00 | $15,135.61 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $2,344.23 | Professional | None | $1,096.48 | $1,584.89 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $4,466.84 Typical High $7,079.46 | Facility | None | $831.76 | $4,466.84 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,698.24 | Professional | None | $977.24 | $1,202.26 | $1,698.24 |
Denver HMP Setting Facility Modifier None Typical Low $977.24 Median $1,258.93 Typical High $2,041.74 | Facility | None | $977.24 | $1,258.93 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,819.70 | Professional | None | $912.01 | $1,202.26 | $1,819.70 |
Select Health Setting Facility Modifier None Typical Low $912.01 Median $1,819.70 Typical High $6,165.95 | Facility | None | $912.01 | $1,819.70 | $6,165.95 |
Select Health Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,348.96 | Professional | None | $912.01 | $1,023.29 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,995.26 | Professional | None | $954.99 | $1,258.93 | $1,995.26 |
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 $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $741.31 | Professional | 54 · Surgery only | $724.44 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $691.83 |
Where Colorado sits
The same service costs 7.9 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· 16th of 51
$1,585
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.