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 $5,495.41 Typical High $8,912.51 | Facility | None | $3,090.30 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $4,168.69 | Professional | None | $3,890.45 | $3,890.45 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $15,135.61 Typical High $25,703.96 | Facility | None | $10,000.00 | $15,135.61 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,466.84 Median $6,309.57 Typical High $9,549.93 | Professional | None | $4,466.84 | $6,309.57 | $9,549.93 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $16,595.87 Typical High $26,302.68 | Facility | None | $812.83 | $16,595.87 | $26,302.68 |
Cigna Setting Professional Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $7,079.46 | Professional | None | $4,265.80 | $5,011.87 | $7,079.46 |
Denver HMP Setting Facility Modifier None Typical Low $3,801.89 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,801.89 | $5,011.87 | $7,943.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,467.37 Median $4,570.88 Typical High $7,079.46 | Professional | None | $3,467.37 | $4,570.88 | $7,079.46 |
Select Health Setting Facility Modifier None Typical Low $3,467.37 Median $7,244.36 Typical High $22,908.68 | Facility | None | $3,467.37 | $7,244.36 | $22,908.68 |
Select Health Setting Professional Modifier None Typical Low $3,467.37 Median $4,073.80 Typical High $5,248.07 | Professional | None | $3,467.37 | $4,073.80 | $5,248.07 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $10,000.00 Typical High $22,387.21 | Facility | None | $4,570.88 | $10,000.00 | $22,387.21 |
United Setting Professional Modifier None Typical Low $3,981.07 Median $5,248.07 Typical High $8,317.64 | Professional | None | $3,981.07 | $5,248.07 | $8,317.64 |
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 $1,949.84 Median $1,949.84 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,949.84 | $1,949.84 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $776.25 Typical High $794.33 | Professional | 53 · Discontinued | $776.25 | $776.25 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $2,884.03 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,884.03 | $2,884.03 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $389.05 Typical High $398.11 | Professional | 56 · Pre-op care only | $389.05 | $389.05 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $2,691.53 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $2,691.53 | $2,691.53 | $2,754.23 |
Where Colorado sits
The same service costs 20.4 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· 13th of 51
$6,166
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.