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 $2,089.30 Median $2,089.30 Typical High $3,162.28 | Professional | None | $2,089.30 | $2,089.30 | $3,162.28 |
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 $2,511.89 Median $3,548.13 Typical High $5,248.07 | Professional | None | $2,511.89 | $3,548.13 | $5,248.07 |
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 $2,238.72 Median $3,162.28 Typical High $4,265.80 | Professional | None | $2,238.72 | $3,162.28 | $4,265.80 |
Denver HMP Setting Facility Modifier None Typical Low $2,089.30 Median $2,691.53 Typical High $5,248.07 | Facility | None | $2,089.30 | $2,691.53 | $5,248.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,089.30 Median $2,951.21 Typical High $4,365.16 | Professional | None | $2,089.30 | $2,951.21 | $4,365.16 |
Select Health Setting Facility Modifier None Typical Low $2,089.30 Median $4,168.69 Typical High $4,365.16 | Facility | None | $2,089.30 | $4,168.69 | $4,365.16 |
Select Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,089.30 Typical High $4,073.80 | Professional | None | $1,445.44 | $2,089.30 | $4,073.80 |
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 $2,398.83 Median $3,162.28 Typical High $5,011.87 | Professional | None | $2,398.83 | $3,162.28 | $5,011.87 |
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 $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $501.19 | Professional | 53 · Discontinued | $426.58 | $426.58 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $380.19 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $251.19 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,778.28 |
Where Colorado sits
The same service costs 7.2 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
$3,631
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.