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 $1,659.59 Median $5,495.41 Typical High $12,302.69 | Facility | None | $1,659.59 | $5,495.41 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $1,584.89 Typical High $5,495.41 | Professional | None | $380.19 | $1,584.89 | $5,495.41 |
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 $398.11 Median $1,202.26 Typical High $3,019.95 | Professional | None | $398.11 | $1,202.26 | $3,019.95 |
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 $389.05 Median $831.76 Typical High $2,570.40 | Professional | None | $389.05 | $831.76 | $2,570.40 |
Denver HMP Setting Facility Modifier None Typical Low $380.19 Median $1,479.11 Typical High $2,344.23 | Facility | None | $380.19 | $1,479.11 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $1,071.52 Typical High $2,818.38 | Professional | None | $331.13 | $1,071.52 | $2,818.38 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $2,511.89 Typical High $3,467.37 | Facility | None | $630.96 | $2,511.89 | $3,467.37 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $1,659.59 | Professional | None | $223.87 | $223.87 | $1,659.59 |
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 $398.11 Median $1,230.27 Typical High $2,818.38 | Professional | None | $398.11 | $1,230.27 | $2,818.38 |
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 $190.55 Median $660.69 Typical High $812.83 | Professional | 52 · Reduced service | $190.55 | $660.69 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $263.03 Typical High $331.13 | Professional | 53 · Discontinued | $75.86 | $263.03 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $977.24 Typical High $1,230.27 | Professional | 54 · Surgery only | $288.40 | $977.24 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $199.53 Typical High $245.47 | Professional | 55 · Aftercare only | $57.54 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $131.83 Typical High $165.96 | Professional | 56 · Pre-op care only | $38.02 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $912.01 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $269.15 | $912.01 | $1,148.15 |
Where Colorado sits
The same service costs 5.8 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· 7th of 51
$2,138
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.