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 $1,071.52 Median $1,096.48 Typical High $5,495.41 | Professional | None | $1,071.52 | $1,096.48 | $5,495.41 |
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 $1,047.13 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,380.38 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,801.89 Typical High $6,025.60 | Facility | None | $758.58 | $3,801.89 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,479.11 | $1,949.84 |
Denver HMP Setting Facility Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,380.38 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,258.93 Typical High $1,862.09 | Professional | None | $831.76 | $1,258.93 | $1,862.09 |
Select Health Setting Facility Modifier None Typical Low $891.25 Median $1,778.28 Typical High $5,248.07 | Facility | None | $891.25 | $1,778.28 | $5,248.07 |
Select Health Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $891.25 | Professional | None | $616.60 | $616.60 | $891.25 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,230.27 | $1,584.89 | $2,454.71 |
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 $537.03 Median $549.54 Typical High $741.31 | Professional | 52 · Reduced service | $537.03 | $549.54 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $218.78 Typical High $295.12 | Professional | 53 · Discontinued | $213.80 | $218.78 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $831.76 Typical High $1,096.48 | Professional | 54 · Surgery only | $794.33 | $831.76 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $165.96 Typical High $218.78 | Professional | 55 · Aftercare only | $158.49 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $109.65 Typical High $147.91 | Professional | 56 · Pre-op care only | $107.15 | $109.65 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $776.25 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $741.31 | $776.25 | $1,023.29 |
Where Colorado sits
The same service costs 5.0 times more in Wisconsin 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· 3rd of 51
$3,020
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.