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 $2,818.38 Median $2,818.38 Typical High $3,630.78 | Professional | None | $2,818.38 | $2,818.38 | $3,630.78 |
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 $3,235.94 Median $4,570.88 Typical High $6,918.31 | Professional | None | $3,235.94 | $4,570.88 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $5,623.41 Typical High $8,912.51 | Facility | None | $812.83 | $5,623.41 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $2,884.03 Median $3,548.13 Typical High $5,011.87 | Professional | None | $2,884.03 | $3,548.13 | $5,011.87 |
Denver HMP Setting Facility Modifier None Typical Low $2,818.38 Median $3,630.78 Typical High $5,754.40 | Facility | None | $2,818.38 | $3,630.78 | $5,754.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,511.89 Median $3,388.44 Typical High $5,128.61 | Professional | None | $2,511.89 | $3,388.44 | $5,128.61 |
Select Health Setting Facility Modifier None Typical Low $2,511.89 Median $5,370.32 Typical High $7,762.47 | Facility | None | $2,511.89 | $5,370.32 | $7,762.47 |
Select Health Setting Professional Modifier None Typical Low $2,511.89 Median $2,951.21 Typical High $3,801.89 | Professional | None | $2,511.89 | $2,951.21 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $2,818.38 Median $3,715.35 Typical High $5,888.44 | Professional | None | $2,818.38 | $3,715.35 | $5,888.44 |
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 $1,412.54 Median $1,412.54 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,412.54 | $1,412.54 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $562.34 Typical High $575.44 | Professional | 53 · Discontinued | $562.34 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $2,137.96 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | 56 · Pre-op care only | $281.84 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,995.26 | $1,995.26 | $1,995.26 |
Where Colorado sits
The same service costs 19.1 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· 15th of 51
$4,266
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.