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 $1,659.59 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,659.59 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $660.69 | Professional | None | $489.78 | $645.65 | $660.69 |
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 $562.34 Median $794.33 Typical High $1,174.90 | Professional | None | $562.34 | $794.33 | $1,174.90 |
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 $562.34 Median $741.31 Typical High $1,122.02 | Professional | None | $562.34 | $741.31 | $1,122.02 |
Denver HMP Setting Facility Modifier None Typical Low $489.78 Median $707.95 Typical High $1,071.52 | Facility | None | $489.78 | $707.95 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,148.15 | Professional | None | $549.54 | $776.25 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $1,230.27 Typical High $2,754.23 | Facility | None | $660.69 | $1,230.27 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $691.83 | Professional | None | $489.78 | $588.84 | $691.83 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,288.25 | Professional | None | $537.03 | $758.58 | $1,288.25 |
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 $245.47 Median $316.23 Typical High $331.13 | Professional | 52 · Reduced service | $245.47 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $125.89 Typical High $131.83 | Professional | 53 · Discontinued | $97.72 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $467.74 Typical High $501.19 | Professional | 54 · Surgery only | $363.08 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $93.33 Typical High $100.00 | Professional | 55 · Aftercare only | $74.13 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $63.10 Typical High $66.07 | Professional | 56 · Pre-op care only | $48.98 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $436.52 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $338.84 | $436.52 | $467.74 |
Where Colorado sits
The same service costs 5.8 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· 19th of 51
$813
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.