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 $1,000.00 Median $1,000.00 Typical High $2,570.40 | Professional | None | $1,000.00 | $1,000.00 | $2,570.40 |
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 $1,258.93 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,819.70 | $2,630.27 |
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 $1,096.48 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,513.56 | $2,089.30 |
Denver HMP Setting Facility Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,995.26 | Facility | None | $1,000.00 | $1,318.26 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,412.54 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,041.74 Typical High $2,137.96 | Facility | None | $1,000.00 | $2,041.74 | $2,137.96 |
Select Health Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,949.84 | Professional | None | $707.95 | $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 $1,122.02 Median $1,479.11 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,479.11 | $2,398.83 |
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 $501.19 Median $501.19 Typical High $602.56 | Professional | 52 · Reduced service | $501.19 | $501.19 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | 53 · Discontinued | $199.53 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $891.25 | Professional | 54 · Surgery only | $758.58 | $758.58 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $177.83 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $120.23 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $831.76 |
Where Colorado sits
The same service costs 7.1 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· 10th 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.