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 $1,348.96 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,348.96 | $1,698.24 |
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 $1,513.56 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,513.56 | $2,187.76 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $5,248.07 Typical High $9,332.54 | Facility | None | $724.44 | $5,248.07 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,584.89 | $2,344.23 |
Denver HMP Setting Facility Modifier None Typical Low $977.24 Median $1,584.89 Typical High $2,818.38 | Facility | None | $977.24 | $1,584.89 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,230.27 | $1,621.81 | $2,454.71 |
Select Health Setting Facility Modifier None Typical Low $1,230.27 Median $2,454.71 Typical High $8,128.31 | Facility | None | $1,230.27 | $2,454.71 | $8,128.31 |
Select Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,412.54 | $1,862.09 |
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 $831.76 Median $1,659.59 Typical High $2,754.23 | Professional | None | $831.76 | $1,659.59 | $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 $676.08 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,023.29 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $204.17 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $954.99 |
Where Colorado sits
The same service costs 8.9 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· 12th of 51
$2,188
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.