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 $3,090.30 Median $6,025.60 Typical High $12,589.25 | Facility | None | $3,090.30 | $6,025.60 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $7,079.46 | Professional | None | $1,513.56 | $1,513.56 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $11,481.54 Median $16,982.44 Typical High $38,904.51 | Facility | None | $11,481.54 | $16,982.44 | $38,904.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $2,630.27 Typical High $4,168.69 | Professional | None | $1,995.26 | $2,630.27 | $4,168.69 |
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 $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Denver HMP Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,570.40 | Facility | None | $1,513.56 | $1,513.56 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,949.84 | $2,754.23 |
Select Health Setting Facility Modifier None Typical Low $1,380.38 Median $2,754.23 Typical High $2,884.03 | Facility | None | $1,380.38 | $2,754.23 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,380.38 | Professional | None | $954.99 | $954.99 | $1,380.38 |
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 $2,398.83 Median $3,090.30 Typical High $4,897.79 | Professional | None | $2,398.83 | $3,090.30 | $4,897.79 |
5 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 $758.58 Median $758.58 Typical High $1,000.00 | Professional | 52 · Reduced service | $758.58 | $758.58 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $398.11 | Professional | 53 · Discontinued | $302.00 | $302.00 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $302.00 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $199.53 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $199.53 |
Where Colorado sits
The same service costs 5.8 times more in California than in Arkansas. 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· 5th of 51
$3,548
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.