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 $1,202.26 Median $1,202.26 Typical High $2,570.40 | Professional | None | $1,202.26 | $1,202.26 | $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 $1,412.54 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,412.54 | $1,995.26 | $2,951.21 |
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 $1,230.27 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,737.80 | $2,398.83 |
Denver HMP Setting Facility Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $3,090.30 | Facility | None | $1,202.26 | $1,513.56 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,698.24 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $1,230.27 Median $2,454.71 Typical High $2,570.40 | Facility | None | $1,230.27 | $2,454.71 | $2,570.40 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $2,398.83 | Professional | None | $851.14 | $1,230.27 | $2,398.83 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,380.38 Typical High $4,786.30 | Facility | None | $660.69 | $1,380.38 | $4,786.30 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,348.96 | $1,778.28 | $2,818.38 |
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 $602.56 Median $602.56 Typical High $707.95 | Professional | 52 · Reduced service | $602.56 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $288.40 | Professional | 53 · Discontinued | $239.88 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $213.80 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $141.25 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $1,000.00 |
Where Colorado sits
The same service costs 5.6 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
$2,138
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.