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 $954.99 Median $954.99 Typical High $1,548.82 | Professional | None | $954.99 | $954.99 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $7,244.36 Typical High $13,182.57 | Facility | None | $4,570.88 | $7,244.36 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,621.81 | $2,398.83 |
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 $1,000.00 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,445.44 | $1,905.46 |
Denver HMP Setting Facility Modifier None Typical Low $954.99 Median $1,230.27 Typical High $2,454.71 | Facility | None | $954.99 | $1,230.27 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $2,041.74 | Professional | None | $977.24 | $1,380.38 | $2,041.74 |
Select Health Setting Facility Modifier None Typical Low $977.24 Median $1,949.84 Typical High $2,041.74 | Facility | None | $977.24 | $1,949.84 | $2,041.74 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $1,905.46 | Professional | None | $691.83 | $977.24 | $1,905.46 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,412.54 | $2,238.72 |
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 $478.63 Typical High $575.44 | Professional | 52 · Reduced service | $478.63 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $229.09 | Professional | 53 · Discontinued | $194.98 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $870.96 | Professional | 54 · Surgery only | $724.44 | $724.44 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $173.78 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $114.82 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $812.83 |
Where Colorado sits
The same service costs 6.8 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· 12th 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.