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 $2,570.40 Median $5,495.41 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $6,025.60 | Professional | None | $954.99 | $954.99 | $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 $1,096.48 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,513.56 | $2,238.72 |
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 $1,023.29 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,380.38 | $1,862.09 |
Denver HMP Setting Facility Modifier None Typical Low $954.99 Median $1,258.93 Typical High $2,137.96 | Facility | None | $954.99 | $1,258.93 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,778.28 | Professional | None | $851.14 | $1,202.26 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $1,778.28 | Facility | None | $851.14 | $1,698.24 | $1,778.28 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,659.59 | Professional | None | $602.56 | $851.14 | $1,659.59 |
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 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,412.54 | $2,187.76 |
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 $478.63 Median $478.63 Typical High $602.56 | Professional | 52 · Reduced service | $478.63 | $478.63 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $239.88 | Professional | 53 · Discontinued | $190.55 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $912.01 | Professional | 54 · Surgery only | $724.44 | $724.44 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $181.97 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $120.23 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $851.14 |
Where Colorado sits
The same service costs 6.6 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· 12th of 51
$1,738
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.