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 $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $2,570.40 | Professional | None | $891.25 | $891.25 | $2,570.40 |
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 $1,023.29 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,412.54 | $2,089.30 |
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 $954.99 Median $1,288.25 Typical High $1,737.80 | Professional | None | $954.99 | $1,288.25 | $1,737.80 |
Denver HMP Setting Facility Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,995.26 | Facility | None | $891.25 | $1,174.90 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,698.24 | Professional | None | $794.33 | $1,122.02 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $794.33 Median $1,584.89 Typical High $1,698.24 | Facility | None | $794.33 | $1,584.89 | $1,698.24 |
Select Health Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,548.82 | Professional | None | $562.34 | $794.33 | $1,548.82 |
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 $1,023.29 Median $1,288.25 Typical High $2,041.74 | Professional | None | $1,023.29 | $1,288.25 | $2,041.74 |
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 $446.68 Median $446.68 Typical High $562.34 | Professional | 52 · Reduced service | $446.68 | $446.68 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $223.87 | Professional | 53 · Discontinued | $181.97 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $851.14 | Professional | 54 · Surgery only | $676.08 | $676.08 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $169.82 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $112.20 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $794.33 |
Where Colorado sits
The same service costs 5.6 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· 11th of 51
$1,585
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.