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 $1,412.54 Median $1,412.54 Typical High $2,570.40 | Professional | None | $1,412.54 | $1,412.54 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $15,135.61 Typical High $25,703.96 | Facility | None | $9,772.37 | $15,135.61 | $25,703.96 |
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 $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 $1,445.44 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,445.44 | $2,041.74 | $2,818.38 |
Denver HMP Setting Facility Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $3,548.13 | Facility | None | $1,380.38 | $1,778.28 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,412.54 | $1,995.26 | $2,951.21 |
Select Health Setting Facility Modifier None Typical Low $1,412.54 Median $2,818.38 Typical High $2,951.21 | Facility | None | $1,412.54 | $2,818.38 | $2,951.21 |
Select Health Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $2,754.23 | Professional | None | $977.24 | $1,412.54 | $2,754.23 |
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 $1,621.81 Median $2,089.30 Typical High $3,311.31 | Professional | None | $1,621.81 | $2,089.30 | $3,311.31 |
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 $707.95 Median $707.95 Typical High $831.76 | Professional | 52 · Reduced service | $707.95 | $707.95 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $331.13 | Professional | 53 · Discontinued | $281.84 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $251.19 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,174.90 |
Where Colorado sits
The same service costs 7.8 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
$2,512
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.