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 $1,412.54 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,412.54 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $1,412.54 Typical High $2,344.23 | Professional | None | $398.11 | $1,412.54 | $2,344.23 |
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 $489.78 Median $1,479.11 Typical High $2,951.21 | Professional | None | $489.78 | $1,479.11 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,778.28 Typical High $2,691.53 | Facility | None | $758.58 | $1,778.28 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $1,380.38 Typical High $2,951.21 | Professional | None | $537.03 | $1,380.38 | $2,951.21 |
Denver HMP Setting Facility Modifier None Typical Low $398.11 Median $1,412.54 Typical High $3,630.78 | Facility | None | $398.11 | $1,412.54 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $977.24 Typical High $2,454.71 | Professional | None | $398.11 | $977.24 | $2,454.71 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $1,819.70 Typical High $3,090.30 | Facility | None | $724.44 | $1,819.70 | $3,090.30 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $707.95 Typical High $2,884.03 | Professional | None | $251.19 | $707.95 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $537.03 Median $1,737.80 Typical High $3,715.35 | Professional | None | $537.03 | $1,737.80 | $3,715.35 |
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 $199.53 Median $616.60 Typical High $741.31 | Professional | 52 · Reduced service | $199.53 | $616.60 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $245.47 Typical High $295.12 | Professional | 53 · Discontinued | $79.43 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $912.01 Typical High $1,096.48 | Professional | 54 · Surgery only | $295.12 | $912.01 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $181.97 Typical High $218.78 | Professional | 55 · Aftercare only | $58.88 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $123.03 Typical High $147.91 | Professional | 56 · Pre-op care only | $39.81 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $851.14 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $275.42 | $851.14 | $1,023.29 |
Where Colorado sits
The same service costs 4.9 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
$1,905
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.