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 $3,235.94 Typical High $8,912.51 | Facility | None | $2,570.40 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $2,511.89 | Professional | None | $1,000.00 | $1,174.90 | $2,511.89 |
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 $1,380.38 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,949.84 | $2,884.03 |
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 $1,023.29 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,548.82 | $2,344.23 |
Denver HMP Setting Facility Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $3,019.95 | Facility | None | $1,071.52 | $1,288.25 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,698.24 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $2,398.83 Typical High $2,511.89 | Facility | None | $1,202.26 | $2,398.83 | $2,511.89 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $2,344.23 | Professional | None | $851.14 | $1,202.26 | $2,344.23 |
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 $1,023.29 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,023.29 | $1,659.59 | $2,630.27 |
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 $588.84 Median $588.84 Typical High $676.08 | Professional | 52 · Reduced service | $588.84 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $269.15 | Professional | 53 · Discontinued | $234.42 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $204.17 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $134.90 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $954.99 |
Where Colorado sits
The same service costs 5.6 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· 10th 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.