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 $2,187.76 Median $5,495.41 Typical High $10,964.78 | Facility | None | $2,187.76 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $6,025.60 | Professional | None | $676.08 | $676.08 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $11,481.54 Typical High $18,620.87 | Facility | None | $7,585.78 | $11,481.54 | $18,620.87 |
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 $933.25 Median $3,801.89 Typical High $5,754.40 | Facility | None | $933.25 | $3,801.89 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,412.54 | Professional | None | $776.25 | $1,047.13 | $1,412.54 |
Denver HMP Setting Facility Modifier None Typical Low $676.08 Median $933.25 Typical High $1,288.25 | Facility | None | $676.08 | $933.25 | $1,288.25 |
Kaiser Permanente 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 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $1,288.25 Typical High $5,011.87 | Facility | None | $645.65 | $1,288.25 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $1,258.93 | Professional | None | $446.68 | $645.65 | $1,258.93 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
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 $338.84 Median $338.84 Typical High $407.38 | Professional | 52 · Reduced service | $338.84 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | 53 · Discontinued | $134.90 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $602.56 | Professional | 54 · Surgery only | $501.19 | $501.19 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $123.03 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $562.34 |
Where Colorado sits
The same service costs 6.5 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· 11th of 51
$1,479
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.