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 $1,258.93 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $602.56 | Professional | None | $371.54 | $549.54 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $870.96 | Professional | None | $407.38 | $588.84 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,659.59 Typical High $2,290.87 | Facility | None | $588.84 | $1,659.59 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $537.03 Typical High $954.99 | Professional | None | $323.59 | $537.03 | $954.99 |
Denver HMP Setting Facility Modifier None Typical Low $371.54 Median $575.44 Typical High $912.01 | Facility | None | $371.54 | $575.44 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $1,096.48 | Professional | None | $446.68 | $691.83 | $1,096.48 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $1,230.27 Typical High $1,949.84 | Facility | None | $660.69 | $1,230.27 | $1,949.84 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $660.69 | Professional | None | $363.08 | $478.63 | $660.69 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,413.10 | Facility | None | $1,288.25 | $2,511.89 | $7,413.10 |
United Setting Professional Modifier None Typical Low $354.81 Median $562.34 Typical High $1,071.52 | Professional | None | $354.81 | $562.34 | $1,071.52 |
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 $186.21 Median $234.42 Typical High $302.00 | Professional | 52 · Reduced service | $186.21 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $95.50 Typical High $120.23 | Professional | 53 · Discontinued | $74.13 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $354.81 Typical High $446.68 | Professional | 54 · Surgery only | $275.42 | $354.81 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $70.79 Typical High $89.13 | Professional | 55 · Aftercare only | $54.95 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $46.77 Typical High $60.26 | Professional | 56 · Pre-op care only | $37.15 | $46.77 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $331.13 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $257.04 | $331.13 | $416.87 |
Where Colorado sits
The same service costs 4.7 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· 22nd of 51
$617
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.