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 $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,148.15 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $13,182.57 Typical High $21,379.62 | Facility | None | $9,772.37 | $13,182.57 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,584.89 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,344.23 Typical High $4,786.30 | Facility | None | $676.08 | $2,344.23 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,412.54 | $1,862.09 |
Denver HMP Setting Facility Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $2,398.83 | Facility | None | $1,148.15 | $1,318.26 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,995.26 | Professional | None | $954.99 | $1,348.96 | $1,995.26 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $1,905.46 Typical High $1,995.26 | Facility | None | $954.99 | $1,905.46 | $1,995.26 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,862.09 | Professional | None | $660.69 | $954.99 | $1,862.09 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,445.44 | $2,290.87 |
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 $549.54 Median $575.44 Typical High $588.84 | Professional | 52 · Reduced service | $549.54 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $229.09 Typical High $234.42 | Professional | 53 · Discontinued | $218.78 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $851.14 Typical High $870.96 | Professional | 54 · Surgery only | $812.83 | $851.14 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $169.82 Typical High $173.78 | Professional | 55 · Aftercare only | $162.18 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $117.49 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $794.33 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $758.58 | $794.33 | $812.83 |
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· 11th of 51
$1,778
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.