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 $1,122.02 Median $1,122.02 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,122.02 | $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 $1,258.93 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,778.28 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,290.87 Typical High $4,786.30 | Facility | None | $676.08 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,202.26 | $1,584.89 | $2,137.96 |
Denver HMP Setting Facility Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $2,454.71 | Facility | None | $1,122.02 | $1,513.56 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,412.54 | $2,089.30 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $2,089.30 | Facility | None | $1,000.00 | $1,995.26 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,949.84 | Professional | None | $691.83 | $1,000.00 | $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 $1,258.93 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,258.93 | $1,621.81 | $2,511.89 |
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 $562.34 Median $562.34 Typical High $707.95 | Professional | 52 · Reduced service | $562.34 | $562.34 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $281.84 | Professional | 53 · Discontinued | $223.87 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,047.13 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $213.80 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $141.25 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $1,000.00 |
Where Colorado sits
The same service costs 5.9 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
$1,995
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.