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 $562.34 Median $691.83 Typical High $1,659.59 | Professional | None | $562.34 | $691.83 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,122.02 | Professional | None | $537.03 | $758.58 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,630.78 Typical High $5,754.40 | Facility | None | $831.76 | $3,630.78 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,096.48 | Professional | None | $562.34 | $758.58 | $1,096.48 |
Denver HMP Setting Facility Modifier None Typical Low $562.34 Median $758.58 Typical High $1,071.52 | Facility | None | $562.34 | $758.58 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $1,096.48 | Professional | None | $467.74 | $724.44 | $1,096.48 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $1,202.26 Typical High $5,011.87 | Facility | None | $645.65 | $1,202.26 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $302.00 Median $645.65 Typical High $1,258.93 | Professional | None | $302.00 | $645.65 | $1,258.93 |
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 $575.44 Median $776.25 Typical High $1,230.27 | Professional | None | $575.44 | $776.25 | $1,230.27 |
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 $275.42 Median $316.23 Typical High $371.54 | Professional | 52 · Reduced service | $275.42 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $125.89 Typical High $147.91 | Professional | 53 · Discontinued | $112.20 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $467.74 Typical High $549.54 | Professional | 54 · Surgery only | $416.87 | $467.74 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $93.33 Typical High $109.65 | Professional | 55 · Aftercare only | $83.18 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $63.10 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $436.52 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $389.05 | $436.52 | $512.86 |
Where Colorado sits
The same service costs 5.0 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· 16th of 51
$912
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.