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 $2,398.83 Median $3,235.94 Typical High $8,912.51 | Facility | None | $2,398.83 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,388.44 | Professional | None | $2,398.83 | $2,398.83 | $3,388.44 |
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 $2,884.03 Median $4,073.80 Typical High $6,025.60 | Professional | None | $2,884.03 | $4,073.80 | $6,025.60 |
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 $2,511.89 Median $3,467.37 Typical High $4,786.30 | Professional | None | $2,511.89 | $3,467.37 | $4,786.30 |
Denver HMP Setting Facility Modifier None Typical Low $2,398.83 Median $3,090.30 Typical High $5,888.44 | Facility | None | $2,398.83 | $3,090.30 | $5,888.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,344.23 Median $3,311.31 Typical High $5,011.87 | Professional | None | $2,344.23 | $3,311.31 | $5,011.87 |
Select Health Setting Facility Modifier None Typical Low $2,344.23 Median $4,677.35 Typical High $5,011.87 | Facility | None | $2,344.23 | $4,677.35 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,344.23 Typical High $4,570.88 | Professional | None | $1,659.59 | $2,344.23 | $4,570.88 |
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 $3,548.13 Typical High $5,754.40 | Professional | None | $2,630.27 | $3,548.13 | $5,754.40 |
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 $1,202.26 Median $1,202.26 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $575.44 | Professional | 53 · Discontinued | $478.63 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $426.58 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $288.40 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $1,995.26 |
Where Colorado sits
The same service costs 10.0 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
$4,074
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.