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 $616.60 Median $616.60 Typical High $676.08 | Professional | None | $616.60 | $616.60 | $676.08 |
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 $1,548.82 | Professional | None | $724.44 | $1,023.29 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,737.80 Typical High $2,691.53 | Facility | None | $724.44 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,096.48 | Professional | None | $645.65 | $758.58 | $1,096.48 |
Denver HMP Setting Facility Modifier None Typical Low $616.60 Median $794.33 Typical High $1,548.82 | Facility | None | $616.60 | $794.33 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,230.27 | Professional | None | $616.60 | $831.76 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $1,230.27 Typical High $1,995.26 | Facility | None | $616.60 | $1,230.27 | $1,995.26 |
Select Health Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $933.25 | Professional | None | $616.60 | $660.69 | $933.25 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $10,232.93 | Facility | None | $1,479.11 | $3,548.13 | $10,232.93 |
United Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,288.25 | Professional | None | $602.56 | $812.83 | $1,288.25 |
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 $309.03 Median $309.03 Typical High $323.59 | Professional | 52 · Reduced service | $309.03 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $128.82 | Professional | 53 · Discontinued | $123.03 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $489.78 | Professional | 54 · Surgery only | $467.74 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $97.72 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $64.57 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $457.09 |
Where Colorado sits
The same service costs 5.8 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· 12th of 51
$1,047
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.