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 $4,365.16 Typical High $11,748.98 | Facility | None | $2,570.40 | $4,365.16 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $4,466.84 | Professional | None | $1,202.26 | $1,202.26 | $4,466.84 |
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 $1,288.25 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,659.59 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $4,168.69 Typical High $5,754.40 | Facility | None | $1,318.26 | $4,168.69 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,202.26 | $1,380.38 | $1,862.09 |
Denver HMP Setting Facility Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,691.53 | Facility | None | $1,202.26 | $1,548.82 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,445.44 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $5,011.87 | Facility | None | $1,071.52 | $2,137.96 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,513.56 | Professional | None | $758.58 | $1,071.52 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,230.27 | $1,445.44 | $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 $602.56 Median $602.56 Typical High $724.44 | Professional | 52 · Reduced service | $602.56 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $288.40 | Professional | 53 · Discontinued | $245.47 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $218.78 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $1,000.00 |
Where Colorado sits
The same service costs 5.5 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· 18th of 51
$2,188
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.