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 $478.63 Median $489.78 Typical High $3,162.28 | Professional | None | $478.63 | $489.78 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,202.26 | Professional | None | $575.44 | $812.83 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,778.28 Typical High $2,454.71 | Facility | None | $588.84 | $1,778.28 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $954.99 | Professional | None | $489.78 | $691.83 | $954.99 |
Denver HMP Setting Facility Modifier None Typical Low $446.68 Median $588.84 Typical High $954.99 | Facility | None | $446.68 | $588.84 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,047.13 | Professional | None | $489.78 | $691.83 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $489.78 Median $1,000.00 Typical High $2,089.30 | Facility | None | $489.78 | $1,000.00 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $954.99 | Professional | None | $346.74 | $489.78 | $954.99 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,122.02 | Professional | None | $524.81 | $691.83 | $1,122.02 |
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 $245.47 Median $245.47 Typical High $269.15 | Professional | 52 · Reduced service | $245.47 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $107.15 | Professional | 53 · Discontinued | $97.72 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $407.38 | Professional | 54 · Surgery only | $371.54 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $81.28 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $53.70 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $380.19 |
Where Colorado sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 11th of 51
$1,000
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.