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 $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $5,495.41 | Professional | None | $851.14 | $891.25 | $5,495.41 |
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 $851.14 Median $1,122.02 Typical High $1,778.28 | Professional | None | $851.14 | $1,122.02 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,548.82 | Professional | None | $870.96 | $1,148.15 | $1,548.82 |
Denver HMP Setting Facility Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,949.84 | Facility | None | $891.25 | $1,096.48 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,621.81 | Professional | None | $741.31 | $1,096.48 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $776.25 Median $1,548.82 Typical High $1,621.81 | Facility | None | $776.25 | $1,548.82 | $1,621.81 |
Select Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $776.25 | Professional | None | $549.54 | $549.54 | $776.25 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,949.84 | Professional | None | $912.01 | $1,202.26 | $1,949.84 |
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 $426.58 Median $446.68 Typical High $588.84 | Professional | 52 · Reduced service | $426.58 | $446.68 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $234.42 | Professional | 53 · Discontinued | $169.82 | $177.83 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $676.08 Typical High $870.96 | Professional | 54 · Surgery only | $645.65 | $676.08 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $134.90 Typical High $173.78 | Professional | 55 · Aftercare only | $128.82 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $117.49 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $630.96 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $602.56 | $630.96 | $812.83 |
Where Colorado sits
The same service costs 4.6 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· 9th of 51
$1,549
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.