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 $1,513.56 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,513.56 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $6,025.60 | Professional | None | $1,862.09 | $2,089.30 | $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 $2,041.74 Median $2,884.03 Typical High $4,365.16 | Professional | None | $2,041.74 | $2,884.03 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,951.21 Typical High $5,754.40 | Facility | None | $588.84 | $2,951.21 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $3,388.44 | Professional | None | $1,778.28 | $2,454.71 | $3,388.44 |
Denver HMP Setting Facility Modifier None Typical Low $1,862.09 Median $2,238.72 Typical High $4,073.80 | Facility | None | $1,862.09 | $2,238.72 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $2,290.87 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,290.87 | $3,467.37 |
Select Health Setting Facility Modifier None Typical Low $1,659.59 Median $3,311.31 Typical High $5,011.87 | Facility | None | $1,659.59 | $3,311.31 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,659.59 Typical High $3,235.94 | Professional | None | $1,148.15 | $1,659.59 | $3,235.94 |
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 $1,862.09 Median $2,454.71 Typical High $3,890.45 | Professional | None | $1,862.09 | $2,454.71 | $3,890.45 |
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 $977.24 Median $1,023.29 Typical High $1,047.13 | Professional | 52 · Reduced service | $977.24 | $1,023.29 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $389.05 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,445.44 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $309.03 Typical High $316.23 | Professional | 55 · Aftercare only | $295.12 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $194.98 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,445.44 | $1,445.44 |
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· 12th of 51
$3,236
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.