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 $10,964.78 | Facility | None | $2,570.40 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,445.44 | $2,089.30 |
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 $1,659.59 Median $2,398.83 Typical High $3,548.13 | Professional | None | $1,659.59 | $2,398.83 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $5,623.41 Typical High $8,912.51 | Facility | None | $812.83 | $5,623.41 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,479.11 | $1,819.70 | $2,570.40 |
Denver HMP Setting Facility Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $3,019.95 | Facility | None | $1,445.44 | $1,862.09 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,778.28 | $2,630.27 |
Select Health Setting Facility Modifier None Typical Low $1,318.26 Median $2,818.38 Typical High $7,762.47 | Facility | None | $1,318.26 | $2,818.38 | $7,762.47 |
Select Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,318.26 | $1,513.56 | $1,995.26 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,479.11 | $1,905.46 | $3,019.95 |
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 $724.44 Median $724.44 Typical High $741.31 | Professional | 52 · Reduced service | $724.44 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $147.91 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,023.29 |
Where Colorado sits
The same service costs 8.7 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· 16th of 51
$2,344
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.