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 $1,318.26 Median $1,318.26 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,318.26 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $11,220.18 Typical High $18,620.87 | Facility | None | $7,244.36 | $11,220.18 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $2,344.23 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,344.23 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,995.26 Typical High $2,754.23 | Professional | None | $1,445.44 | $1,995.26 | $2,754.23 |
Denver HMP Setting Facility Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $2,630.27 | Facility | None | $1,318.26 | $1,737.80 | $2,630.27 |
Kaiser Permanente 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 |
Select Health Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $2,754.23 | Facility | None | $1,318.26 | $2,630.27 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $2,570.40 | Professional | None | $933.25 | $1,318.26 | $2,570.40 |
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 $1,513.56 Median $1,995.26 Typical High $3,235.94 | Professional | None | $1,513.56 | $1,995.26 | $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 $660.69 Median $660.69 Typical High $812.83 | Professional | 52 · Reduced service | $660.69 | $660.69 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $323.59 | Professional | 53 · Discontinued | $263.03 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,230.27 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $245.47 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $162.18 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,148.15 |
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· 11th of 51
$2,455
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.