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 $2,691.53 Median $5,495.41 Typical High $12,882.50 | Facility | None | $2,691.53 | $5,495.41 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $5,495.41 | Professional | None | $1,698.24 | $1,905.46 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
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 $1,778.28 Median $4,365.16 Typical High $6,760.83 | Facility | None | $1,778.28 | $4,365.16 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,238.72 Typical High $3,162.28 | Professional | None | $1,584.89 | $2,238.72 | $3,162.28 |
Denver HMP Setting Facility Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $3,715.35 | Facility | None | $1,862.09 | $2,137.96 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,479.11 | $2,089.30 | $3,090.30 |
Select Health Setting Facility Modifier None Typical Low $1,479.11 Median $2,951.21 Typical High $5,011.87 | Facility | None | $1,479.11 | $2,951.21 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $2,884.03 | Professional | None | $1,047.13 | $1,479.11 | $2,884.03 |
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 $1,737.80 Median $2,238.72 Typical High $3,630.78 | Professional | None | $1,737.80 | $2,238.72 | $3,630.78 |
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 $891.25 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $891.25 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $354.81 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,412.54 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,318.26 | $1,412.54 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $281.84 Typical High $288.40 | Professional | 55 · Aftercare only | $263.03 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $177.83 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,318.26 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,318.26 | $1,348.96 |
Where Colorado sits
The same service costs 6.3 times more in Alaska than in Utah. 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· 8th of 51
$3,090
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.