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 $1,318.26 Median $1,318.26 Typical High $1,698.24 | Facility | None | $1,318.26 | $1,318.26 | $1,698.24 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,318.26 | $1,698.24 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,548.82 | $2,137.96 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,288.25 Typical High $2,691.53 | Facility | None | $758.58 | $1,288.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,621.81 | $2,089.30 | $2,951.21 |
Denver HMP Setting Facility Modifier None Typical Low $1,318.26 Median $2,137.96 Typical High $2,754.23 | Facility | None | $1,318.26 | $2,137.96 | $2,754.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,412.54 | $2,041.74 | $3,019.95 |
Select Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $3,715.35 | Facility | None | $1,258.93 | $1,778.28 | $3,715.35 |
Select Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,318.26 | $1,513.56 | $1,778.28 |
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 $1,584.89 Median $2,137.96 Typical High $3,311.31 | Professional | None | $1,584.89 | $2,137.96 | $3,311.31 |
5 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 $660.69 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $660.69 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $263.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $251.19 Typical High $257.04 | Professional | 55 · Aftercare only | $199.53 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $131.83 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $933.25 | $1,174.90 | $1,174.90 |
Where Colorado sits
The same service costs 5.1 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· 17th of 51
$2,188
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.