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 $2,691.53 Median $5,495.41 Typical High $12,882.50 | Facility | None | $2,691.53 | $5,495.41 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $5,495.41 | Professional | None | $851.14 | $851.14 | $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 $1,071.52 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,513.56 | $2,238.72 |
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 $977.24 Median $1,288.25 Typical High $1,819.70 | Professional | None | $977.24 | $1,288.25 | $1,819.70 |
Denver HMP Setting Facility Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,621.81 | Facility | None | $851.14 | $1,174.90 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $1,698.24 | Professional | None | $812.83 | $1,148.15 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $1,621.81 Typical High $1,698.24 | Facility | None | $812.83 | $1,621.81 | $1,698.24 |
Select Health Setting Professional Modifier None Typical Low $562.34 Median $812.83 Typical High $1,584.89 | Professional | None | $562.34 | $812.83 | $1,584.89 |
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 $1,023.29 Median $1,318.26 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,318.26 | $2,089.30 |
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 $426.58 Median $426.58 Typical High $512.86 | Professional | 52 · Reduced service | $426.58 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $204.17 | Professional | 53 · Discontinued | $169.82 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | 54 · Surgery only | $630.96 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $151.36 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $102.33 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $707.95 |
Where Colorado sits
The same service costs 6.3 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· 9th of 51
$1,698
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.