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 $3,715.35 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,148.15 | $1,412.54 |
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 $1,288.25 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,862.09 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,344.23 Typical High $3,311.31 | Facility | None | $831.76 | $2,344.23 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,174.90 | $1,445.44 | $2,041.74 |
Denver HMP Setting Facility Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,454.71 | Facility | None | $1,148.15 | $1,513.56 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,412.54 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $2,754.23 | Facility | None | $1,071.52 | $2,137.96 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,174.90 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,479.11 | $2,290.87 |
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 $575.44 Median $575.44 Typical High $588.84 | Professional | 52 · Reduced service | $575.44 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $234.42 | Professional | 53 · Discontinued | $229.09 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $870.96 | Professional | 54 · Surgery only | $851.14 | $851.14 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $117.49 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $812.83 |
Where Colorado sits
The same service costs 7.9 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· 11th of 51
$1,862
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.