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 $3,235.94 Typical High $8,912.51 | Facility | None | $2,570.40 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $2,570.40 | Professional | None | $794.33 | $794.33 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,862.09 | Professional | None | $891.25 | $1,258.93 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,398.83 Typical High $3,235.94 | Facility | None | $758.58 | $2,398.83 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,513.56 | Professional | None | $851.14 | $1,122.02 | $1,513.56 |
Denver HMP Setting Facility Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,778.28 | Facility | None | $794.33 | $1,047.13 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,479.11 | Professional | None | $707.95 | $1,000.00 | $1,479.11 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $1,412.54 Typical High $2,884.03 | Facility | None | $707.95 | $1,412.54 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $1,380.38 | Professional | None | $501.19 | $707.95 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,762.47 | Facility | None | $1,288.25 | $2,511.89 | $7,762.47 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,778.28 | Professional | None | $912.01 | $1,148.15 | $1,778.28 |
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 $398.11 Median $398.11 Typical High $501.19 | Professional | 52 · Reduced service | $398.11 | $398.11 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $199.53 | Professional | 53 · Discontinued | $158.49 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $602.56 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $151.36 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $100.00 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $707.95 |
Where Colorado sits
The same service costs 5.8 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· 9th of 51
$1,514
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.