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 $1,995.26 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $6,025.60 | Professional | None | $512.86 | $512.86 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,348.96 | Professional | None | $645.65 | $912.01 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,071.52 | Professional | None | $562.34 | $758.58 | $1,071.52 |
Denver HMP Setting Facility Modifier None Typical Low $512.86 Median $691.83 Typical High $1,023.29 | Facility | None | $512.86 | $691.83 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $1,071.52 | Professional | None | $512.86 | $724.44 | $1,071.52 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $1,023.29 Typical High $1,071.52 | Facility | None | $512.86 | $1,023.29 | $1,071.52 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $1,000.00 | Professional | None | $354.81 | $512.86 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $3,548.13 Typical High $10,000.00 | Facility | None | $1,445.44 | $3,548.13 | $10,000.00 |
United Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,258.93 | Professional | None | $602.56 | $776.25 | $1,258.93 |
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 $257.04 Median $257.04 Typical High $302.00 | Professional | 52 · Reduced service | $257.04 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $123.03 | Professional | 53 · Discontinued | $104.71 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $457.09 | Professional | 54 · Surgery only | $389.05 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $61.66 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $426.58 |
Where Colorado sits
The same service costs 6.0 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· 8th of 51
$1,122
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.