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 $1,659.59 Median $1,778.28 Typical High $6,165.95 | Professional | None | $1,659.59 | $1,778.28 | $6,165.95 |
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 $1,778.28 Median $2,454.71 Typical High $3,630.78 | Professional | None | $1,778.28 | $2,454.71 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,715.35 Typical High $5,754.40 | Facility | None | $758.58 | $3,715.35 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,621.81 | $2,089.30 | $2,884.03 |
Denver HMP Setting Facility Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $3,388.44 | Facility | None | $1,737.80 | $1,778.28 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $2,818.38 | Professional | None | $1,348.96 | $1,905.46 | $2,818.38 |
Select Health Setting Facility Modifier None Typical Low $1,348.96 Median $2,691.53 Typical High $5,011.87 | Facility | None | $1,348.96 | $2,691.53 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $2,630.27 | Professional | None | $954.99 | $1,348.96 | $2,630.27 |
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 $1,698.24 Median $2,137.96 Typical High $3,311.31 | Professional | None | $1,698.24 | $2,137.96 | $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 $831.76 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $831.76 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $354.81 Typical High $363.08 | Professional | 53 · Discontinued | $331.13 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,318.26 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,230.27 | $1,318.26 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $245.47 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $177.83 Typical High $181.97 | Professional | 56 · Pre-op care only | $165.96 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,230.27 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,230.27 | $1,258.93 |
Where Colorado sits
The same service costs 7.1 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· 8th of 51
$2,951
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.