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 $2,041.74 Median $2,041.74 Typical High $2,089.30 | Professional | None | $2,041.74 | $2,041.74 | $2,089.30 |
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 $2,398.83 Median $3,311.31 Typical High $5,011.87 | Professional | None | $2,398.83 | $3,311.31 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,737.80 Typical High $2,691.53 | Facility | None | $812.83 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $2,691.53 Typical High $3,981.07 | Professional | None | $2,238.72 | $2,691.53 | $3,981.07 |
Denver HMP Setting Facility Modifier None Typical Low $2,041.74 Median $2,754.23 Typical High $4,168.69 | Facility | None | $2,041.74 | $2,754.23 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,862.09 Median $2,454.71 Typical High $3,715.35 | Professional | None | $1,862.09 | $2,454.71 | $3,715.35 |
Select Health Setting Facility Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $3,890.45 | Facility | None | $1,698.24 | $1,862.09 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $2,754.23 | Professional | None | $1,862.09 | $2,137.96 | $2,754.23 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $2,187.76 Median $2,818.38 Typical High $4,265.80 | Professional | None | $2,187.76 | $2,818.38 | $4,265.80 |
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 $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $416.87 | Professional | 53 · Discontinued | $407.38 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $208.93 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,445.44 |
Where Colorado sits
The same service costs 19.5 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· 14th of 51
$3,236
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.