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 $1,513.56 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,513.56 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $6,165.95 | Professional | None | $457.09 | $478.63 | $6,165.95 |
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 $446.68 Median $602.56 Typical High $954.99 | Professional | None | $446.68 | $602.56 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,884.03 Typical High $5,495.41 | Facility | None | $588.84 | $2,884.03 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $602.56 Typical High $794.33 | Professional | None | $416.87 | $602.56 | $794.33 |
Denver HMP Setting Facility Modifier None Typical Low $436.52 Median $524.81 Typical High $1,023.29 | Facility | None | $436.52 | $524.81 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $575.44 Typical High $870.96 | Professional | None | $389.05 | $575.44 | $870.96 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $4,897.79 | Facility | None | $407.38 | $812.83 | $4,897.79 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $407.38 | Professional | None | $288.40 | $288.40 | $407.38 |
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 $426.58 Median $602.56 Typical High $1,000.00 | Professional | None | $426.58 | $602.56 | $1,000.00 |
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 $229.09 Median $239.88 Typical High $309.03 | Professional | 52 · Reduced service | $229.09 | $239.88 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $97.72 Typical High $123.03 | Professional | 53 · Discontinued | $91.20 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $363.08 Typical High $457.09 | Professional | 54 · Surgery only | $338.84 | $363.08 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $72.44 Typical High $91.20 | Professional | 55 · Aftercare only | $67.61 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $47.86 Typical High $61.66 | Professional | 56 · Pre-op care only | $45.71 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $338.84 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $316.23 | $338.84 | $426.58 |
Where Colorado sits
The same service costs 5.4 times more in Alaska than in New York. 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
$1,820
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.