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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $6,025.60 | Professional | None | $1,047.13 | $1,071.52 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,513.56 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,479.11 Typical High $2,691.53 | Facility | None | $691.83 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,348.96 | $1,819.70 |
Denver HMP Setting Facility Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,778.28 | Facility | None | $1,071.52 | $1,318.26 | $1,778.28 |
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 $1,548.82 Typical High $1,778.28 | Facility | None | $851.14 | $1,548.82 | $1,778.28 |
Select Health Setting Professional Modifier None Typical Low $588.84 Median $851.14 Typical High $1,659.59 | Professional | None | $588.84 | $851.14 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $10,232.93 | Facility | None | $1,479.11 | $3,548.13 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,412.54 | $2,137.96 |
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 $524.81 Typical High $588.84 | Professional | 52 · Reduced service | $478.63 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $213.80 Typical High $239.88 | Professional | 53 · Discontinued | $190.55 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $794.33 Typical High $891.25 | Professional | 54 · Surgery only | $707.95 | $794.33 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $158.49 Typical High $177.83 | Professional | 55 · Aftercare only | $141.25 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $107.15 Typical High $120.23 | Professional | 56 · Pre-op care only | $95.50 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $741.31 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $660.69 | $741.31 | $831.76 |
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· 10th of 51
$1,778
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.