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 $1,995.26 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,311.31 | Professional | None | $2,630.27 | $2,630.27 | $3,311.31 |
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 $3,019.95 Median $4,265.80 Typical High $6,309.57 | Professional | None | $3,019.95 | $4,265.80 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $6,606.93 Typical High $8,912.51 | Facility | None | $812.83 | $6,606.93 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $3,311.31 Typical High $4,677.35 | Professional | None | $2,691.53 | $3,311.31 | $4,677.35 |
Denver HMP Setting Facility Modifier None Typical Low $2,398.83 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,398.83 | $3,311.31 | $5,370.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,344.23 Median $3,162.28 Typical High $4,786.30 | Professional | None | $2,344.23 | $3,162.28 | $4,786.30 |
Select Health Setting Facility Modifier None Typical Low $2,344.23 Median $4,897.79 Typical High $7,762.47 | Facility | None | $2,344.23 | $4,897.79 | $7,762.47 |
Select Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $3,548.13 | Professional | None | $2,344.23 | $2,691.53 | $3,548.13 |
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 $2,630.27 Median $3,467.37 Typical High $5,495.41 | Professional | None | $2,630.27 | $3,467.37 | $5,495.41 |
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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $398.11 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $1,862.09 |
Where Colorado sits
The same service costs 8.7 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
$4,169
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.