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 $1,230.27 Median $1,288.25 Typical High $6,025.60 | Professional | None | $1,230.27 | $1,288.25 | $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 $1,258.93 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,659.59 | $2,570.40 |
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 $1,288.25 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,288.25 | $1,698.24 | $2,290.87 |
Denver HMP Setting Facility Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,691.53 | Facility | None | $1,288.25 | $1,621.81 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,513.56 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $2,238.72 | Facility | None | $1,071.52 | $2,137.96 | $2,238.72 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,071.52 | Professional | None | $758.58 | $758.58 | $1,071.52 |
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 $1,348.96 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,348.96 | $1,778.28 | $2,884.03 |
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 $616.60 Median $645.65 Typical High $851.14 | Professional | 52 · Reduced service | $616.60 | $645.65 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $257.04 Typical High $346.74 | Professional | 53 · Discontinued | $251.19 | $257.04 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $977.24 Typical High $1,288.25 | Professional | 54 · Surgery only | $933.25 | $977.24 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $194.98 Typical High $257.04 | Professional | 55 · Aftercare only | $186.21 | $194.98 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $128.82 Typical High $173.78 | Professional | 56 · Pre-op care only | $123.03 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $912.01 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $870.96 | $912.01 | $1,202.26 |
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· 8th of 51
$2,239
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.