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 $2,454.71 Median $2,570.40 Typical High $6,025.60 | Professional | None | $2,454.71 | $2,570.40 | $6,025.60 |
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 $2,454.71 Median $3,235.94 Typical High $5,128.61 | Professional | None | $2,454.71 | $3,235.94 | $5,128.61 |
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 $2,511.89 Median $3,388.44 Typical High $4,570.88 | Professional | None | $2,511.89 | $3,388.44 | $4,570.88 |
Denver HMP Setting Facility Modifier None Typical Low $2,570.40 Median $3,090.30 Typical High $5,248.07 | Facility | None | $2,570.40 | $3,090.30 | $5,248.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,995.26 Median $2,951.21 Typical High $4,365.16 | Professional | None | $1,995.26 | $2,951.21 | $4,365.16 |
Select Health Setting Facility Modifier None Typical Low $2,089.30 Median $4,168.69 Typical High $4,365.16 | Facility | None | $2,089.30 | $4,168.69 | $4,365.16 |
Select Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,445.44 | $2,089.30 |
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 $2,691.53 Median $3,630.78 Typical High $5,754.40 | Professional | None | $2,691.53 | $3,630.78 | $5,754.40 |
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 $1,230.27 Median $1,288.25 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,230.27 | $1,288.25 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $512.86 Typical High $691.83 | Professional | 53 · Discontinued | $501.19 | $512.86 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,905.46 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,862.09 | $1,905.46 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $389.05 Typical High $512.86 | Professional | 55 · Aftercare only | $371.54 | $389.05 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $257.04 Typical High $346.74 | Professional | 56 · Pre-op care only | $245.47 | $257.04 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,778.28 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,778.28 | $2,398.83 |
Where Colorado sits
The same service costs 6.9 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
$3,802
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.