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 $6,025.60 Typical High $11,220.18 | Facility | None | $2,570.40 | $6,025.60 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,047.13 | Professional | None | $831.76 | $831.76 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $15,135.61 Median $19,054.61 Typical High $43,651.58 | Facility | None | $15,135.61 | $19,054.61 | $43,651.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,995.26 | Professional | None | $954.99 | $1,348.96 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $6,606.93 Typical High $12,882.50 | Facility | None | $933.25 | $6,606.93 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,445.44 | Professional | None | $831.76 | $1,023.29 | $1,445.44 |
Denver HMP Setting Facility Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,737.80 | Facility | None | $831.76 | $1,047.13 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,548.82 | Professional | None | $776.25 | $1,023.29 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $776.25 Median $1,548.82 Typical High $11,220.18 | Facility | None | $776.25 | $1,548.82 | $11,220.18 |
Select Health Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,174.90 | Professional | None | $776.25 | $870.96 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $9,332.54 Typical High $23,442.29 | Facility | None | $1,949.84 | $9,332.54 | $23,442.29 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,698.24 | Professional | None | $812.83 | $1,071.52 | $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 $416.87 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $588.84 |
Where Colorado sits
The same service costs 16.2 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
$1,349
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.