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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $5,495.41 | Professional | None | $1,096.48 | $1,148.15 | $5,495.41 |
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 $1,148.15 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,621.81 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,311.31 Typical High $5,128.61 | Facility | None | $691.83 | $3,311.31 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,479.11 | $1,949.84 |
Denver HMP Setting Facility Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $1,949.84 | Facility | None | $1,148.15 | $1,445.44 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,905.46 | Professional | None | $912.01 | $1,288.25 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $912.01 Median $1,819.70 Typical High $4,570.88 | Facility | None | $912.01 | $1,819.70 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,778.28 | Professional | None | $645.65 | $912.01 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,174.90 | $1,513.56 | $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 $512.86 Median $575.44 Typical High $645.65 | Professional | 52 · Reduced service | $512.86 | $575.44 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $229.09 Typical High $257.04 | Professional | 53 · Discontinued | $204.17 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $851.14 Typical High $977.24 | Professional | 54 · Surgery only | $776.25 | $851.14 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $173.78 Typical High $194.98 | Professional | 55 · Aftercare only | $154.88 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $114.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $102.33 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $794.33 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $724.44 | $794.33 | $912.01 |
Where Colorado sits
The same service costs 5.6 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
$1,950
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.