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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,288.25 | Professional | None | $1,000.00 | $1,000.00 | $1,288.25 |
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 $1,174.90 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,659.59 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,715.35 Typical High $5,754.40 | Facility | None | $758.58 | $3,715.35 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,380.38 | $1,949.84 |
Denver HMP Setting Facility Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $2,137.96 | Facility | None | $1,000.00 | $1,412.54 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,862.09 | Professional | None | $912.01 | $1,230.27 | $1,862.09 |
Select Health Setting Facility Modifier None Typical Low $912.01 Median $1,862.09 Typical High $5,011.87 | Facility | None | $912.01 | $1,862.09 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,380.38 | Professional | None | $912.01 | $1,047.13 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,479.11 | $2,398.83 |
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 $501.19 Median $501.19 Typical High $524.81 | Professional | 52 · Reduced service | $501.19 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $208.93 | Professional | 53 · Discontinued | $204.17 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $794.33 | Professional | 54 · Surgery only | $758.58 | $758.58 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $158.49 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $104.71 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $741.31 |
Where Colorado sits
The same service costs 7.9 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· 15th of 51
$1,698
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.