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 $1,023.29 Median $1,047.13 Typical High $6,025.60 | Professional | None | $1,023.29 | $1,047.13 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,318.26 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,344.23 Typical High $3,090.30 | Facility | None | $758.58 | $2,344.23 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $1,862.09 | Professional | None | $1,148.15 | $1,412.54 | $1,862.09 |
Denver HMP Setting Facility Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $2,089.30 | Facility | None | $1,047.13 | $1,288.25 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $1,778.28 | Professional | None | $794.33 | $1,202.26 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $2,691.53 | Facility | None | $851.14 | $1,698.24 | $2,691.53 |
Select Health Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $851.14 | Professional | None | $588.84 | $588.84 | $851.14 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,479.11 | $2,344.23 |
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 $501.19 Median $524.81 Typical High $691.83 | Professional | 52 · Reduced service | $501.19 | $524.81 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $208.93 Typical High $281.84 | Professional | 53 · Discontinued | $204.17 | $208.93 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $776.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $758.58 | $776.25 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $158.49 Typical High $208.93 | Professional | 55 · Aftercare only | $151.36 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $104.71 Typical High $141.25 | Professional | 56 · Pre-op care only | $102.33 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $724.44 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $707.95 | $724.44 | $977.24 |
Where Colorado sits
The same service costs 4.7 times more in Wisconsin 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· 4th 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.