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 $1,479.11 Median $1,584.89 Typical High $6,165.95 | Professional | None | $1,479.11 | $1,584.89 | $6,165.95 |
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 $1,621.81 Median $2,290.87 Typical High $3,388.44 | Professional | None | $1,621.81 | $2,290.87 | $3,388.44 |
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 $1,513.56 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,513.56 | $2,041.74 | $2,754.23 |
Denver HMP Setting Facility Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $2,691.53 | Facility | None | $1,584.89 | $2,041.74 | $2,691.53 |
Kaiser Permanente 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 |
Select Health Setting Facility Modifier None Typical Low $1,258.93 Median $2,511.89 Typical High $4,570.88 | Facility | None | $1,258.93 | $2,511.89 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $2,454.71 | Professional | None | $891.25 | $1,258.93 | $2,454.71 |
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 $1,621.81 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,621.81 | $2,137.96 | $3,235.94 |
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 $724.44 Median $794.33 Typical High $912.01 | Professional | 52 · Reduced service | $724.44 | $794.33 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $316.23 Typical High $363.08 | Professional | 53 · Discontinued | $288.40 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,202.26 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,071.52 | $1,202.26 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $239.88 Typical High $269.15 | Professional | 55 · Aftercare only | $213.80 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $158.49 Typical High $181.97 | Professional | 56 · Pre-op care only | $144.54 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,122.02 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,122.02 | $1,258.93 |
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
$2,692
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.