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 $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,659.59 | Professional | None | $1,621.81 | $1,621.81 | $1,659.59 |
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 $1,862.09 Median $2,630.27 Typical High $3,890.45 | Professional | None | $1,862.09 | $2,630.27 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $9,772.37 Typical High $17,378.01 | Facility | None | $812.83 | $9,772.37 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $2,951.21 | Professional | None | $1,621.81 | $2,041.74 | $2,951.21 |
Denver HMP Setting Facility Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $3,311.31 | Facility | None | $1,621.81 | $2,041.74 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $2,951.21 | Professional | None | $1,479.11 | $1,949.84 | $2,951.21 |
Select Health Setting Facility Modifier None Typical Low $1,479.11 Median $3,090.30 Typical High $15,488.17 | Facility | None | $1,479.11 | $3,090.30 | $15,488.17 |
Select Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,187.76 | Professional | None | $1,479.11 | $1,698.24 | $2,187.76 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $10,000.00 Typical High $22,387.21 | Facility | None | $4,570.88 | $10,000.00 | $22,387.21 |
United Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $3,311.31 | Professional | None | $1,621.81 | $2,089.30 | $3,311.31 |
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 $812.83 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $331.13 | Professional | 53 · Discontinued | $323.59 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,148.15 |
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· 14th of 51
$2,630
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.