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 $2,089.30 Median $2,344.23 Typical High $5,495.41 | Professional | None | $2,089.30 | $2,344.23 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,715.19 Median $13,182.57 Typical High $24,547.09 | Facility | None | $10,715.19 | $13,182.57 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,290.87 Median $3,019.95 Typical High $4,677.35 | Professional | None | $2,290.87 | $3,019.95 | $4,677.35 |
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 $2,398.83 Median $3,162.28 Typical High $4,265.80 | Professional | None | $2,398.83 | $3,162.28 | $4,265.80 |
Denver HMP Setting Facility Modifier None Typical Low $2,344.23 Median $2,951.21 Typical High $4,786.30 | Facility | None | $2,344.23 | $2,951.21 | $4,786.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,819.70 Median $2,691.53 Typical High $4,073.80 | Professional | None | $1,819.70 | $2,691.53 | $4,073.80 |
Select Health Setting Facility Modifier None Typical Low $1,949.84 Median $3,890.45 Typical High $4,073.80 | Facility | None | $1,949.84 | $3,890.45 | $4,073.80 |
Select Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,348.96 | $1,949.84 |
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 $2,511.89 Median $3,388.44 Typical High $5,248.07 | Professional | None | $2,511.89 | $3,388.44 | $5,248.07 |
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 $1,148.15 Median $1,174.90 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,148.15 | $1,174.90 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $467.74 Typical High $630.96 | Professional | 53 · Discontinued | $457.09 | $467.74 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,778.28 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,698.24 | $1,778.28 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $354.81 Typical High $478.63 | Professional | 55 · Aftercare only | $338.84 | $354.81 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $234.42 Typical High $316.23 | Professional | 56 · Pre-op care only | $229.09 | $234.42 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,659.59 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,659.59 | $2,187.76 |
Where Colorado sits
The same service costs 5.4 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
$3,548
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.