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 $3,090.30 Median $6,025.60 Typical High $8,912.51 | Facility | None | $3,090.30 | $6,025.60 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $6,025.60 Typical High $6,025.60 | Professional | None | $1,659.59 | $6,025.60 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $7,244.36 Typical High $13,182.57 | Facility | None | $4,786.30 | $7,244.36 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,318.26 | $1,778.28 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,344.23 Typical High $4,786.30 | Facility | None | $676.08 | $2,344.23 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $562.34 Typical High $812.83 | Professional | None | $346.74 | $562.34 | $812.83 |
Denver HMP Setting Facility Modifier None Typical Low $5,495.41 Median $6,025.60 Typical High $8,709.64 | Facility | None | $5,495.41 | $6,025.60 | $8,709.64 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $346.74 Typical High $7,413.10 | Professional | None | $154.88 | $346.74 | $7,413.10 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
7 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 $831.76 Median $3,019.95 Typical High $3,019.95 | Professional | 52 · Reduced service | $831.76 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $1,230.27 Typical High $1,230.27 | Professional | 53 · Discontinued | $331.13 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $4,570.88 Typical High $4,570.88 | Professional | 54 · Surgery only | $1,230.27 | $4,570.88 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $912.01 Typical High $912.01 | Professional | 55 · Aftercare only | $245.47 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $602.56 Typical High $602.56 | Professional | 56 · Pre-op care only | $165.96 | $602.56 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $169.82 Typical High $213.80 | Professional | 80 · Assistant surgeon | $104.71 | $169.82 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $147.91 Typical High $186.21 | Professional | AS · PA/NP assist | $91.20 | $147.91 | $186.21 |
Where Colorado sits
The same service costs 204.2 times more in Wisconsin than in Hawaii. 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· 10th 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.