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 $1,778.28 Median $1,778.28 Typical High $2,290.87 | Professional | None | $1,778.28 | $1,778.28 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,951.21 Typical High $4,365.16 | Professional | None | $2,089.30 | $2,951.21 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,786.30 Typical High $7,244.36 | Facility | None | $812.83 | $4,786.30 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $3,388.44 | Professional | None | $2,041.74 | $2,398.83 | $3,388.44 |
Denver HMP Setting Facility Modifier None Typical Low $1,778.28 Median $2,511.89 Typical High $3,630.78 | Facility | None | $1,778.28 | $2,511.89 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $2,089.30 Typical High $3,235.94 | Professional | None | $1,548.82 | $2,089.30 | $3,235.94 |
Select Health Setting Facility Modifier None Typical Low $1,548.82 Median $3,311.31 Typical High $6,309.57 | Facility | None | $1,548.82 | $3,311.31 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,548.82 | $1,862.09 | $2,344.23 |
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 $1,862.09 Median $2,454.71 Typical High $4,073.80 | Professional | None | $1,862.09 | $2,454.71 | $4,073.80 |
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 $891.25 Median $891.25 Typical High $912.01 | Professional | 52 · Reduced service | $891.25 | $891.25 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $363.08 | Professional | 53 · Discontinued | $354.81 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $275.42 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $181.97 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,288.25 |
Where Colorado sits
The same service costs 20.0 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· 12th of 51
$2,951
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.