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 $1,862.09 Median $1,949.84 Typical High $6,025.60 | Professional | None | $1,862.09 | $1,949.84 | $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 $1,819.70 Median $2,454.71 Typical High $3,890.45 | Professional | None | $1,819.70 | $2,454.71 | $3,890.45 |
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 $1,949.84 Median $2,570.40 Typical High $3,388.44 | Professional | None | $1,949.84 | $2,570.40 | $3,388.44 |
Denver HMP Setting Facility Modifier None Typical Low $1,949.84 Median $2,454.71 Typical High $4,073.80 | Facility | None | $1,949.84 | $2,454.71 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $2,290.87 Typical High $3,388.44 | Professional | None | $1,548.82 | $2,290.87 | $3,388.44 |
Select Health Setting Facility Modifier None Typical Low $1,621.81 Median $3,235.94 Typical High $3,388.44 | Facility | None | $1,621.81 | $3,235.94 | $3,388.44 |
Select Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,122.02 | $1,621.81 |
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 $2,041.74 Median $2,630.27 Typical High $4,265.80 | Professional | None | $2,041.74 | $2,630.27 | $4,265.80 |
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 $933.25 Median $954.99 Typical High $1,288.25 | Professional | 52 · Reduced service | $933.25 | $954.99 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $389.05 Typical High $512.86 | Professional | 53 · Discontinued | $371.54 | $389.05 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,445.44 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,380.38 | $1,445.44 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $288.40 Typical High $389.05 | Professional | 55 · Aftercare only | $281.84 | $288.40 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $194.98 Typical High $257.04 | Professional | 56 · Pre-op care only | $186.21 | $194.98 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,348.96 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,348.96 | $1,819.70 |
Where Colorado sits
The same service costs 5.8 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· 11th of 51
$3,162
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.