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 $2,137.96 Median $2,344.23 Typical High $3,467.37 | Professional | None | $2,137.96 | $2,344.23 | $3,467.37 |
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 $2,754.23 Median $3,890.45 Typical High $5,754.40 | Professional | None | $2,754.23 | $3,890.45 | $5,754.40 |
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 $2,187.76 Median $3,311.31 Typical High $4,677.35 | Professional | None | $2,187.76 | $3,311.31 | $4,677.35 |
Denver HMP Setting Facility Modifier None Typical Low $2,344.23 Median $2,951.21 Typical High $5,754.40 | Facility | None | $2,344.23 | $2,951.21 | $5,754.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,290.87 Median $3,235.94 Typical High $4,786.30 | Professional | None | $2,290.87 | $3,235.94 | $4,786.30 |
Select Health Setting Facility Modifier None Typical Low $2,290.87 Median $4,570.88 Typical High $4,786.30 | Facility | None | $2,290.87 | $4,570.88 | $4,786.30 |
Select Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,290.87 Typical High $4,466.84 | Professional | None | $1,621.81 | $2,290.87 | $4,466.84 |
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 $2,630.27 Median $3,388.44 Typical High $5,495.41 | Professional | None | $2,630.27 | $3,388.44 | $5,495.41 |
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 $1,174.90 Median $1,174.90 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $549.54 | Professional | 53 · Discontinued | $467.74 | $467.74 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $407.38 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $269.15 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,905.46 |
Where Colorado sits
The same service costs 6.0 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· 12th of 51
$3,981
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.