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 $12,589.25 | Facility | None | $2,570.40 | $5,495.41 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $6,025.60 | Professional | None | $1,148.15 | $1,148.15 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $7,244.36 Typical High $13,182.57 | Facility | None | $4,786.30 | $7,244.36 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,819.70 | $2,754.23 |
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 $1,230.27 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,659.59 | $2,238.72 |
Denver HMP Setting Facility Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,570.40 | Facility | None | $1,148.15 | $1,513.56 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,445.44 | $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 $724.44 Median $1,023.29 Typical High $1,995.26 | Professional | None | $724.44 | $1,023.29 | $1,995.26 |
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 $1,318.26 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,698.24 | $2,630.27 |
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 $575.44 Median $575.44 Typical High $724.44 | Professional | 52 · Reduced service | $575.44 | $575.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $295.12 | Professional | 53 · Discontinued | $234.42 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,096.48 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $218.78 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $147.91 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $1,023.29 |
Where Colorado sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 10th of 51
$2,138
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.