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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,071.52 | Professional | None | $933.25 | $933.25 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,548.82 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $812.83 Typical High $2,691.53 | Facility | None | $602.56 | $812.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,621.81 | Professional | None | $794.33 | $1,071.52 | $1,621.81 |
Denver HMP Setting Facility Modifier None Typical Low $831.76 Median $1,000.00 Typical High $2,344.23 | Facility | None | $831.76 | $1,000.00 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,905.46 | Professional | None | $954.99 | $1,258.93 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $954.99 Typical High $1,995.26 | Facility | None | $758.58 | $954.99 | $1,995.26 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,412.54 | Professional | None | $954.99 | $1,000.00 | $1,412.54 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,174.90 Typical High $2,951.21 | Facility | None | $489.78 | $1,174.90 | $2,951.21 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,905.46 | Professional | None | $812.83 | $1,122.02 | $1,905.46 |
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 $467.74 Median $467.74 Typical High $478.63 | Professional | 52 · Reduced service | $467.74 | $467.74 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $190.55 | Professional | 53 · Discontinued | $186.21 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $144.54 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $95.50 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $660.69 |
Where Colorado sits
The same service costs 22.4 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· 15th of 51
$1,413
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.