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 $1,659.59 Median $1,698.24 Typical High $6,025.60 | Professional | None | $1,659.59 | $1,698.24 | $6,025.60 |
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 $1,659.59 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,187.76 | $3,467.37 |
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 $1,698.24 Median $2,290.87 Typical High $3,019.95 | Professional | None | $1,698.24 | $2,290.87 | $3,019.95 |
Denver HMP Setting Facility Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $3,548.13 | Facility | None | $1,698.24 | $2,137.96 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,348.96 | $2,041.74 | $3,019.95 |
Select Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,884.03 Typical High $3,019.95 | Facility | None | $1,445.44 | $2,884.03 | $3,019.95 |
Select Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,445.44 | Professional | None | $1,000.00 | $1,000.00 | $1,445.44 |
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 $1,737.80 Median $2,344.23 Typical High $3,801.89 | Professional | None | $1,737.80 | $2,344.23 | $3,801.89 |
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 $851.14 Typical High $1,148.15 | Professional | 52 · Reduced service | $831.76 | $851.14 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $346.74 Typical High $457.09 | Professional | 53 · Discontinued | $331.13 | $346.74 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,288.25 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,230.27 | $1,288.25 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $257.04 Typical High $338.84 | Professional | 55 · Aftercare only | $245.47 | $257.04 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $169.82 Typical High $229.09 | Professional | 56 · Pre-op care only | $165.96 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,202.26 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,202.26 | $1,584.89 |
Where Colorado sits
The same service costs 5.6 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· 11th of 51
$2,818
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.