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 $3,548.13 | Professional | None | $2,818.38 | $2,818.38 | $3,548.13 |
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 $3,162.28 Median $4,570.88 Typical High $6,760.83 | Professional | None | $3,162.28 | $4,570.88 | $6,760.83 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $4,466.84 Typical High $7,079.46 | Facility | None | $831.76 | $4,466.84 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $3,311.31 Typical High $4,897.79 | Professional | None | $2,630.27 | $3,311.31 | $4,897.79 |
Denver HMP Setting Facility Modifier None Typical Low $2,818.38 Median $3,388.44 Typical High $5,754.40 | Facility | None | $2,818.38 | $3,388.44 | $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 $5,011.87 Typical High $6,165.95 | Facility | None | $2,511.89 | $5,011.87 | $6,165.95 |
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 $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 $2,454.71 Median $3,467.37 Typical High $5,623.41 | Professional | None | $2,454.71 | $3,467.37 | $5,623.41 |
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 $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,412.54 | $1,412.54 | $1,412.54 |
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 $2,089.30 Median $2,089.30 Typical High $2,137.96 | Professional | 54 · Surgery only | $2,089.30 | $2,089.30 | $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 $281.84 | Professional | 56 · Pre-op care only | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $1,949.84 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,949.84 | $1,949.84 | $1,995.26 |
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· 13th 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.