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 $575.44 Median $575.44 Typical High $2,454.71 | Professional | None | $575.44 | $575.44 | $2,454.71 |
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 $724.44 Median $1,023.29 Typical High $1,513.56 | Professional | None | $724.44 | $1,023.29 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,818.38 Typical High $4,365.16 | Facility | None | $758.58 | $2,818.38 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,202.26 | Professional | None | $645.65 | $851.14 | $1,202.26 |
Denver HMP Setting Facility Modifier None Typical Low $575.44 Median $776.25 Typical High $1,096.48 | Facility | None | $575.44 | $776.25 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,148.15 | Professional | None | $549.54 | $776.25 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $1,096.48 Typical High $3,801.89 | Facility | None | $549.54 | $1,096.48 | $3,801.89 |
Select Health Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $1,071.52 | Professional | None | $389.05 | $549.54 | $1,071.52 |
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 $676.08 Median $891.25 Typical High $1,412.54 | Professional | None | $676.08 | $891.25 | $1,412.54 |
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 $288.40 Median $288.40 Typical High $338.84 | Professional | 52 · Reduced service | $288.40 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $138.04 | Professional | 53 · Discontinued | $114.82 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $512.86 | Professional | 54 · Surgery only | $426.58 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $102.33 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $69.18 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $478.63 |
Where Colorado sits
The same service costs 6.2 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
$1,259
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.