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 $1,071.52 Typical High $4,570.88 | Professional | None | $1,071.52 | $1,071.52 | $4,570.88 |
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 $1,023.29 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,348.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,344.23 Typical High $3,090.30 | Facility | None | $758.58 | $2,344.23 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,174.90 | $1,445.44 | $1,905.46 |
Denver HMP Setting Facility Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $2,137.96 | Facility | None | $1,071.52 | $1,348.96 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,202.26 Typical High $1,819.70 | Professional | None | $812.83 | $1,202.26 | $1,819.70 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $1,737.80 Typical High $2,691.53 | Facility | None | $851.14 | $1,737.80 | $2,691.53 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $851.14 | Professional | None | $602.56 | $602.56 | $851.14 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,548.82 | $2,398.83 |
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 $512.86 Median $537.03 Typical High $724.44 | Professional | 52 · Reduced service | $512.86 | $537.03 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $213.80 Typical High $288.40 | Professional | 53 · Discontinued | $208.93 | $213.80 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $794.33 Typical High $1,071.52 | Professional | 54 · Surgery only | $776.25 | $794.33 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $158.49 Typical High $213.80 | Professional | 55 · Aftercare only | $154.88 | $158.49 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $107.15 Typical High $144.54 | Professional | 56 · Pre-op care only | $102.33 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $741.31 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $724.44 | $741.31 | $1,000.00 |
Where Colorado sits
The same service costs 4.6 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· 4th of 51
$2,239
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.