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 $12,589.25 | Facility | None | $2,570.40 | $5,495.41 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,162.28 | Professional | None | $2,454.71 | $2,454.71 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $15,135.61 Typical High $25,703.96 | Facility | None | $10,000.00 | $15,135.61 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,818.38 Median $3,981.07 Typical High $5,888.44 | Professional | None | $2,818.38 | $3,981.07 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $9,772.37 Typical High $17,378.01 | Facility | None | $812.83 | $9,772.37 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $3,235.94 Typical High $4,570.88 | Professional | None | $2,691.53 | $3,235.94 | $4,570.88 |
Denver HMP Setting Facility Modifier None Typical Low $2,187.76 Median $3,090.30 Typical High $5,011.87 | Facility | None | $2,187.76 | $3,090.30 | $5,011.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,187.76 Median $2,951.21 Typical High $4,466.84 | Professional | None | $2,187.76 | $2,951.21 | $4,466.84 |
Select Health Setting Facility Modifier None Typical Low $2,187.76 Median $4,570.88 Typical High $15,488.17 | Facility | None | $2,187.76 | $4,570.88 | $15,488.17 |
Select Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $3,311.31 | Professional | None | $2,187.76 | $2,570.40 | $3,311.31 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $10,000.00 Typical High $22,387.21 | Facility | None | $4,570.88 | $10,000.00 | $22,387.21 |
United Setting Professional Modifier None Typical Low $2,570.40 Median $3,311.31 Typical High $5,495.41 | Professional | None | $2,570.40 | $3,311.31 | $5,495.41 |
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 $1,230.27 Median $1,230.27 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $501.19 | Professional | 53 · Discontinued | $489.78 | $489.78 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $251.19 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $1,737.80 |
Where Colorado sits
The same service costs 25.7 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
$3,981
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.