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 $3,090.30 Median $5,495.41 Typical High $8,912.51 | Facility | None | $3,090.30 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $3,981.07 Typical High $4,786.30 | Professional | None | $3,548.13 | $3,981.07 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $11,481.54 Median $16,982.44 Typical High $38,904.51 | Facility | None | $11,481.54 | $16,982.44 | $38,904.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,981.07 Median $5,623.41 Typical High $8,317.64 | Professional | None | $3,981.07 | $5,623.41 | $8,317.64 |
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 $3,388.44 Median $5,011.87 Typical High $6,606.93 | Professional | None | $3,388.44 | $5,011.87 | $6,606.93 |
Denver HMP Setting Facility Modifier None Typical Low $3,630.78 Median $4,466.84 Typical High $8,128.31 | Facility | None | $3,630.78 | $4,466.84 | $8,128.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,235.94 Median $4,570.88 Typical High $6,760.83 | Professional | None | $3,235.94 | $4,570.88 | $6,760.83 |
Select Health Setting Facility Modifier None Typical Low $3,235.94 Median $6,456.54 Typical High $6,760.83 | Facility | None | $3,235.94 | $6,456.54 | $6,760.83 |
Select Health Setting Professional Modifier None Typical Low $2,290.87 Median $3,235.94 Typical High $6,309.57 | Professional | None | $2,290.87 | $3,235.94 | $6,309.57 |
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 $3,715.35 Median $5,011.87 Typical High $8,128.31 | Professional | None | $3,715.35 | $5,011.87 | $8,128.31 |
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 $1,949.84 Median $1,995.26 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,949.84 | $1,995.26 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $794.33 Typical High $831.76 | Professional | 53 · Discontinued | $776.25 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $3,019.95 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,884.03 | $3,019.95 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $602.56 Typical High $630.96 | Professional | 55 · Aftercare only | $575.44 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $398.11 Typical High $416.87 | Professional | 56 · Pre-op care only | $389.05 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $2,818.38 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,691.53 | $2,818.38 | $2,951.21 |
Where Colorado sits
The same service costs 10.7 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
$5,623
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.