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 $758.58 Median $851.14 Typical High $2,570.40 | Professional | None | $758.58 | $851.14 | $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 $851.14 Median $1,202.26 Typical High $1,778.28 | Professional | None | $851.14 | $1,202.26 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,454.71 Typical High $3,235.94 | Facility | None | $758.58 | $2,454.71 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,445.44 | Professional | None | $812.83 | $1,071.52 | $1,445.44 |
Denver HMP Setting Facility Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,445.44 | Facility | None | $851.14 | $1,023.29 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,412.54 | Professional | None | $676.08 | $954.99 | $1,412.54 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $1,348.96 Typical High $2,884.03 | Facility | None | $676.08 | $1,348.96 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $1,318.26 | Professional | None | $478.63 | $676.08 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,698.24 | Professional | None | $851.14 | $1,071.52 | $1,698.24 |
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 $380.19 Median $426.58 Typical High $478.63 | Professional | 52 · Reduced service | $380.19 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $169.82 Typical High $190.55 | Professional | 53 · Discontinued | $151.36 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $707.95 | Professional | 54 · Surgery only | $575.44 | $630.96 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $144.54 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $85.11 Typical High $95.50 | Professional | 56 · Pre-op care only | $75.86 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $660.69 |
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· 10th of 51
$1,445
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.