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 $1,995.26 Median $3,801.89 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,786.30 | Professional | None | $3,801.89 | $3,801.89 | $4,786.30 |
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 $4,265.80 Median $6,165.95 Typical High $9,332.54 | Professional | None | $4,265.80 | $6,165.95 | $9,332.54 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $8,912.51 | Facility | None | $758.58 | $5,011.87 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $3,630.78 Median $4,466.84 Typical High $6,456.54 | Professional | None | $3,630.78 | $4,466.84 | $6,456.54 |
Denver HMP Setting Facility Modifier None Typical Low $3,467.37 Median $4,570.88 Typical High $7,762.47 | Facility | None | $3,467.37 | $4,570.88 | $7,762.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,467.37 Median $4,570.88 Typical High $6,918.31 | Professional | None | $3,467.37 | $4,570.88 | $6,918.31 |
Select Health Setting Facility Modifier None Typical Low $3,467.37 Median $7,244.36 Typical High $7,762.47 | Facility | None | $3,467.37 | $7,244.36 | $7,762.47 |
Select Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,890.45 Typical High $5,128.61 | Professional | None | $3,467.37 | $3,890.45 | $5,128.61 |
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 $3,630.78 Median $4,897.79 Typical High $7,585.78 | Professional | None | $3,630.78 | $4,897.79 | $7,585.78 |
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 $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,905.46 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $2,818.38 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,818.38 | $2,818.38 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $562.34 Typical High $575.44 | Professional | 55 · Aftercare only | $562.34 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 56 · Pre-op care only | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $2,630.27 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $2,630.27 | $2,630.27 | $2,691.53 |
Where Colorado sits
The same service costs 20.4 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
$5,495
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.