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 $1,479.11 Median $5,248.07 Typical High $12,302.69 | Facility | None | $1,479.11 | $5,248.07 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $1,318.26 Typical High $2,454.71 | Professional | None | $389.05 | $1,318.26 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,762.47 Typical High $13,182.57 | Facility | None | $6,165.95 | $7,762.47 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $1,318.26 Typical High $2,570.40 | Professional | None | $457.09 | $1,318.26 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,290.87 Typical High $3,090.30 | Facility | None | $691.83 | $2,290.87 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $954.99 Typical High $2,238.72 | Professional | None | $436.52 | $954.99 | $2,238.72 |
Denver HMP Setting Facility Modifier None Typical Low $436.52 Median $1,412.54 Typical High $1,995.26 | Facility | None | $436.52 | $1,412.54 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $933.25 Typical High $2,398.83 | Professional | None | $380.19 | $933.25 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $2,511.89 Typical High $2,951.21 | Facility | None | $724.44 | $2,511.89 | $2,951.21 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $1,412.54 | Professional | None | $251.19 | $251.19 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,748.98 | Facility | None | $1,479.11 | $3,548.13 | $11,748.98 |
United Setting Professional Modifier None Typical Low $467.74 Median $1,380.38 Typical High $2,511.89 | Professional | None | $467.74 | $1,380.38 | $2,511.89 |
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 $218.78 Median $562.34 Typical High $724.44 | Professional | 52 · Reduced service | $218.78 | $562.34 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $223.87 Typical High $288.40 | Professional | 53 · Discontinued | $87.10 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $851.14 Typical High $1,096.48 | Professional | 54 · Surgery only | $331.13 | $851.14 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $169.82 Typical High $218.78 | Professional | 55 · Aftercare only | $66.07 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $112.20 Typical High $144.54 | Professional | 56 · Pre-op care only | $43.65 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $794.33 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $309.03 | $794.33 | $1,023.29 |
Where Colorado sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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
$1,820
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.