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 $1,174.90 Median $1,174.90 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,174.90 | $2,570.40 |
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 $1,862.09 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,862.09 | $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 $1,174.90 Median $1,513.56 Typical High $2,570.40 | Facility | None | $1,174.90 | $1,513.56 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,479.11 | $2,187.76 |
Select Health Setting Facility Modifier None Typical Low $1,047.13 Median $2,089.30 Typical High $2,187.76 | Facility | None | $1,047.13 | $2,089.30 | $2,187.76 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $2,041.74 | Professional | None | $724.44 | $1,047.13 | $2,041.74 |
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 $1,659.59 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,659.59 | $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 $588.84 Median $588.84 Typical High $741.31 | Professional | 52 · Reduced service | $588.84 | $588.84 | $741.31 |
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 $223.87 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $147.91 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $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 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· 12th of 51
$2,089
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.