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 $1,230.27 Median $1,380.38 Typical High $5,495.41 | Professional | None | $1,230.27 | $1,380.38 | $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 $1,380.38 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,949.84 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,630.78 Typical High $5,754.40 | Facility | None | $831.76 | $3,630.78 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,258.93 | $1,737.80 | $2,290.87 |
Denver HMP Setting Facility Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $2,691.53 | Facility | None | $1,318.26 | $1,659.59 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,513.56 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $5,011.87 | Facility | None | $1,071.52 | $2,137.96 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $2,089.30 | Professional | None | $758.58 | $1,071.52 | $2,089.30 |
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 $1,348.96 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,348.96 | $1,737.80 | $2,754.23 |
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 $660.69 Median $691.83 Typical High $707.95 | Professional | 52 · Reduced service | $660.69 | $691.83 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $275.42 Typical High $281.84 | Professional | 53 · Discontinued | $263.03 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,047.13 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,000.00 | $1,047.13 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $208.93 Typical High $213.80 | Professional | 55 · Aftercare only | $199.53 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $138.04 Typical High $141.25 | Professional | 56 · Pre-op care only | $131.83 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $977.24 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $933.25 | $977.24 | $1,000.00 |
Where Colorado sits
The same service costs 6.8 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· 9th 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.