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 $1,348.96 Median $1,412.54 Typical High $5,495.41 | Professional | None | $1,348.96 | $1,412.54 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,348.96 | $1,778.28 | $2,818.38 |
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 $1,412.54 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,862.09 | $2,454.71 |
Denver HMP Setting Facility Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $3,019.95 | Facility | None | $1,412.54 | $1,698.24 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,698.24 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $2,398.83 Typical High $2,511.89 | Facility | None | $1,202.26 | $2,398.83 | $2,511.89 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,202.26 | Professional | None | $831.76 | $831.76 | $1,202.26 |
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 $1,445.44 Median $1,905.46 Typical High $3,162.28 | Professional | None | $1,445.44 | $1,905.46 | $3,162.28 |
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 $676.08 Median $707.95 Typical High $933.25 | Professional | 52 · Reduced service | $676.08 | $707.95 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $281.84 Typical High $380.19 | Professional | 53 · Discontinued | $269.15 | $281.84 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,071.52 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,023.29 | $1,071.52 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $213.80 Typical High $281.84 | Professional | 55 · Aftercare only | $204.17 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $141.25 Typical High $186.21 | Professional | 56 · Pre-op care only | $134.90 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,000.00 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $954.99 | $1,000.00 | $1,318.26 |
Where Colorado sits
The same service costs 4.8 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
$2,455
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.