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 $1,412.54 Median $1,548.82 Typical High $6,025.60 | Professional | None | $1,412.54 | $1,548.82 | $6,025.60 |
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 $1,513.56 Median $2,137.96 Typical High $3,162.28 | Professional | None | $1,513.56 | $2,137.96 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $3,801.89 Typical High $5,754.40 | Facility | None | $933.25 | $3,801.89 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,778.28 | $2,511.89 |
Denver HMP Setting Facility Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $3,019.95 | Facility | None | $1,380.38 | $1,621.81 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,698.24 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $2,398.83 Typical High $5,011.87 | Facility | None | $1,202.26 | $2,398.83 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $2,344.23 | Professional | None | $831.76 | $1,202.26 | $2,344.23 |
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 $1,778.28 Typical High $2,884.03 | Professional | None | $1,348.96 | $1,778.28 | $2,884.03 |
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 $707.95 Median $758.58 Typical High $776.25 | Professional | 52 · Reduced service | $707.95 | $758.58 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $281.84 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,047.13 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $229.09 Typical High $234.42 | Professional | 55 · Aftercare only | $208.93 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $141.25 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $977.24 | $1,071.52 | $1,071.52 |
Where Colorado sits
The same service costs 6.6 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· 10th of 51
$2,570
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.