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 $2,290.87 Median $2,290.87 Typical High $2,951.21 | Professional | None | $2,290.87 | $2,290.87 | $2,951.21 |
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 $2,630.27 Median $3,715.35 Typical High $5,623.41 | Professional | None | $2,630.27 | $3,715.35 | $5,623.41 |
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 $2,344.23 Median $2,884.03 Typical High $4,073.80 | Professional | None | $2,344.23 | $2,884.03 | $4,073.80 |
Denver HMP Setting Facility Modifier None Typical Low $2,290.87 Median $2,884.03 Typical High $4,570.88 | Facility | None | $2,290.87 | $2,884.03 | $4,570.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,995.26 Median $2,691.53 Typical High $4,168.69 | Professional | None | $1,995.26 | $2,691.53 | $4,168.69 |
Select Health Setting Facility Modifier None Typical Low $1,995.26 Median $4,265.80 Typical High $6,309.57 | Facility | None | $1,995.26 | $4,265.80 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,398.83 Typical High $3,019.95 | Professional | None | $1,995.26 | $2,398.83 | $3,019.95 |
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 $2,344.23 Median $3,019.95 Typical High $4,677.35 | Professional | None | $2,344.23 | $3,019.95 | $4,677.35 |
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 $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $467.74 | Professional | 53 · Discontinued | $457.09 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $346.74 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $234.42 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $1,621.81 |
Where Colorado sits
The same service costs 21.9 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
$3,548
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.