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 $1,071.52 Median $1,071.52 Typical High $1,380.38 | Professional | None | $1,071.52 | $1,071.52 | $1,380.38 |
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 $1,202.26 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,202.26 | $1,737.80 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,818.38 Typical High $4,466.84 | Facility | None | $691.83 | $2,818.38 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $1,862.09 | Professional | None | $933.25 | $1,288.25 | $1,862.09 |
Denver HMP Setting Facility Modifier None Typical Low $758.58 Median $1,288.25 Typical High $2,238.72 | Facility | None | $758.58 | $1,288.25 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,318.26 | $1,995.26 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $3,890.45 | Facility | None | $1,000.00 | $1,995.26 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,122.02 | $1,479.11 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,318.26 Typical High $2,187.76 | Professional | None | $660.69 | $1,318.26 | $2,187.76 |
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 $537.03 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $758.58 |
Where Colorado sits
The same service costs 7.8 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
$1,622
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.