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 $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,412.54 | Professional | None | $1,380.38 | $1,380.38 | $1,412.54 |
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 $1,548.82 Median $2,238.72 Typical High $3,311.31 | Professional | None | $1,548.82 | $2,238.72 | $3,311.31 |
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 $1,288.25 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,288.25 | $1,659.59 | $2,454.71 |
Denver HMP Setting Facility Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $2,884.03 | Facility | None | $1,380.38 | $1,698.24 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,698.24 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $1,258.93 Median $2,570.40 Typical High $5,011.87 | Facility | None | $1,258.93 | $2,570.40 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,412.54 | $1,905.46 |
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 $1,288.25 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,737.80 | $2,754.23 |
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 $691.83 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $208.93 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $977.24 |
Where Colorado sits
The same service costs 17.0 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
$2,239
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.