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 $630.96 Median $630.96 Typical High $870.96 | Professional | None | $630.96 | $630.96 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,801.89 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $1,548.82 | Professional | None | $707.95 | $1,023.29 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,348.96 Typical High $3,311.31 | Facility | None | $831.76 | $1,348.96 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,096.48 | Professional | None | $616.60 | $776.25 | $1,096.48 |
Denver HMP Setting Facility Modifier None Typical Low $630.96 Median $758.58 Typical High $1,348.96 | Facility | None | $630.96 | $758.58 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $1,202.26 | Professional | None | $602.56 | $794.33 | $1,202.26 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $1,445.44 | Facility | None | $602.56 | $1,202.26 | $1,445.44 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $912.01 | Professional | None | $602.56 | $660.69 | $912.01 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $10,000.00 | Facility | None | $1,479.11 | $3,548.13 | $10,000.00 |
United Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,258.93 | Professional | None | $588.84 | $794.33 | $1,258.93 |
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 $316.23 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $446.68 |
Where Colorado sits
The same service costs 7.2 times more in Alaska than in Utah. 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
$1,023
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.