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 $1,258.93 Typical High $6,025.60 | Professional | None | $1,230.27 | $1,258.93 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $9,332.54 Typical High $16,218.10 | Facility | None | $5,888.44 | $9,332.54 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,584.89 | $2,511.89 |
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 $1,380.38 Median $1,698.24 Typical High $2,238.72 | Professional | None | $1,380.38 | $1,698.24 | $2,238.72 |
Denver HMP Setting Facility Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,511.89 | Facility | None | $1,258.93 | $1,621.81 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $2,137.96 | Professional | None | $954.99 | $1,412.54 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $1,023.29 Median $2,041.74 Typical High $2,137.96 | Facility | None | $1,023.29 | $2,041.74 | $2,137.96 |
Select Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,023.29 | Professional | None | $707.95 | $707.95 | $1,023.29 |
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 $1,412.54 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,412.54 | $1,862.09 | $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 $630.96 Typical High $851.14 | Professional | 52 · Reduced service | $616.60 | $630.96 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $251.19 Typical High $338.84 | Professional | 53 · Discontinued | $245.47 | $251.19 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $954.99 Typical High $1,258.93 | Professional | 54 · Surgery only | $912.01 | $954.99 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $190.55 Typical High $257.04 | Professional | 55 · Aftercare only | $181.97 | $190.55 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $125.89 Typical High $169.82 | Professional | 56 · Pre-op care only | $123.03 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $891.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $851.14 | $891.25 | $1,174.90 |
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· 8th of 51
$2,291
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.