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 $6,025.60 Typical High $13,489.63 | Facility | None | $2,570.40 | $6,025.60 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,737.80 | $1,737.80 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $2,818.38 Typical High $4,265.80 | Professional | None | $1,949.84 | $2,818.38 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,570.88 Typical High $7,079.46 | Facility | None | $758.58 | $4,570.88 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,548.82 | $1,995.26 | $2,951.21 |
Denver HMP Setting Facility Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $3,890.45 | Facility | None | $1,659.59 | $2,041.74 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $3,548.13 | Professional | None | $1,778.28 | $2,344.23 | $3,548.13 |
Select Health Setting Facility Modifier None Typical Low $1,778.28 Median $3,715.35 Typical High $6,165.95 | Facility | None | $1,778.28 | $3,715.35 | $6,165.95 |
Select Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,737.80 | $1,819.70 | $2,630.27 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,089.30 Typical High $3,548.13 | Professional | None | $1,513.56 | $2,089.30 | $3,548.13 |
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 $870.96 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $177.83 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,230.27 |
Where Colorado sits
The same service costs 11.2 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· 14th of 51
$2,818
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.