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 $1,995.26 Median $5,495.41 Typical High $14,454.40 | Facility | None | $1,995.26 | $5,495.41 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $7,244.36 | Professional | None | $537.03 | $549.54 | $7,244.36 |
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 $524.81 Median $691.83 Typical High $1,096.48 | Professional | None | $524.81 | $691.83 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,162.28 Typical High $4,365.16 | Facility | None | $831.76 | $3,162.28 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $954.99 | Professional | None | $524.81 | $707.95 | $954.99 |
Denver HMP Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $1,202.26 | Facility | None | $549.54 | $676.08 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $1,000.00 | Professional | None | $457.09 | $676.08 | $1,000.00 |
Select Health Setting Facility Modifier None Typical Low $478.63 Median $954.99 Typical High $3,890.45 | Facility | None | $478.63 | $954.99 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $478.63 | Professional | None | $331.13 | $331.13 | $478.63 |
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 $549.54 Median $741.31 Typical High $1,202.26 | Professional | None | $549.54 | $741.31 | $1,202.26 |
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 $263.03 Median $275.42 Typical High $363.08 | Professional | 52 · Reduced service | $263.03 | $275.42 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $144.54 | Professional | 53 · Discontinued | $104.71 | $109.65 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $416.87 Typical High $537.03 | Professional | 54 · Surgery only | $398.11 | $416.87 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $83.18 Typical High $107.15 | Professional | 55 · Aftercare only | $79.43 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $54.95 Typical High $72.44 | Professional | 56 · Pre-op care only | $52.48 | $54.95 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $389.05 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $371.54 | $389.05 | $501.19 |
Where Colorado sits
The same service costs 5.4 times more in Alaska 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
$1,995
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.