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 $2,344.23 Median $2,454.71 Typical High $6,025.60 | Professional | None | $2,344.23 | $2,454.71 | $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 $2,290.87 Median $3,090.30 Typical High $4,897.79 | Professional | None | $2,290.87 | $3,090.30 | $4,897.79 |
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 $1,659.59 Median $3,162.28 Typical High $4,265.80 | Professional | None | $1,659.59 | $3,162.28 | $4,265.80 |
Denver HMP Setting Facility Modifier None Typical Low $1,949.84 Median $2,454.71 Typical High $4,897.79 | Facility | None | $1,949.84 | $2,454.71 | $4,897.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,862.09 Median $2,754.23 Typical High $4,073.80 | Professional | None | $1,862.09 | $2,754.23 | $4,073.80 |
Select Health Setting Facility Modifier None Typical Low $1,949.84 Median $3,890.45 Typical High $4,073.80 | Facility | None | $1,949.84 | $3,890.45 | $4,073.80 |
Select Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,380.38 | $1,949.84 |
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 $1,778.28 Median $3,235.94 Typical High $5,370.32 | Professional | None | $1,778.28 | $3,235.94 | $5,370.32 |
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 $1,174.90 Median $1,230.27 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,174.90 | $1,230.27 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $489.78 Typical High $645.65 | Professional | 53 · Discontinued | $467.74 | $489.78 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,819.70 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,778.28 | $1,819.70 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $371.54 Typical High $489.78 | Professional | 55 · Aftercare only | $354.81 | $371.54 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $245.47 Typical High $323.59 | Professional | 56 · Pre-op care only | $234.42 | $245.47 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,698.24 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,698.24 | $2,238.72 |
Where Colorado sits
The same service costs 5.8 times more in Alaska than in Delaware. 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
$3,631
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.