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 $2,570.40 Median $5,495.41 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,023.29 | $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 $2,454.71 | Professional | None | $1,174.90 | $1,659.59 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $3,801.89 Typical High $5,754.40 | Facility | None | $933.25 | $3,801.89 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,288.25 | $1,819.70 |
Denver HMP Setting Facility Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $2,137.96 | Facility | None | $1,023.29 | $1,318.26 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,862.09 | Professional | None | $933.25 | $1,258.93 | $1,862.09 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $1,862.09 Typical High $5,011.87 | Facility | None | $933.25 | $1,862.09 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,412.54 | Professional | None | $933.25 | $1,047.13 | $1,412.54 |
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 $1,000.00 Median $1,318.26 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,318.26 | $2,089.30 |
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 $512.86 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $776.25 | Professional | 54 · Surgery only | $758.58 | $758.58 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $154.88 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $724.44 |
Where Colorado sits
The same service costs 21.4 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
$1,660
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.