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 $3,090.30 Median $5,495.41 Typical High $8,912.51 | Facility | None | $3,090.30 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $5,370.32 | Professional | None | $3,890.45 | $3,890.45 | $5,370.32 |
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 $4,570.88 Median $6,456.54 Typical High $9,549.93 | Professional | None | $4,570.88 | $6,456.54 | $9,549.93 |
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 $3,981.07 Median $5,754.40 Typical High $7,762.47 | Professional | None | $3,981.07 | $5,754.40 | $7,762.47 |
Denver HMP Setting Facility Modifier None Typical Low $3,890.45 Median $4,897.79 Typical High $9,332.54 | Facility | None | $3,890.45 | $4,897.79 | $9,332.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $7,762.47 | Professional | None | $3,715.35 | $5,248.07 | $7,762.47 |
Select Health Setting Facility Modifier None Typical Low $3,715.35 Median $7,413.10 Typical High $7,762.47 | Facility | None | $3,715.35 | $7,413.10 | $7,762.47 |
Select Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,715.35 Typical High $7,244.36 | Professional | None | $2,630.27 | $3,715.35 | $7,244.36 |
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 $4,365.16 Median $5,888.44 Typical High $9,332.54 | Professional | None | $4,365.16 | $5,888.44 | $9,332.54 |
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 $1,949.84 Median $1,949.84 Typical High $2,344.23 | Professional | 52 · Reduced service | $1,949.84 | $1,949.84 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $776.25 Typical High $933.25 | Professional | 53 · Discontinued | $776.25 | $776.25 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $2,884.03 Typical High $3,467.37 | Professional | 54 · Surgery only | $2,884.03 | $2,884.03 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $575.44 Typical High $691.83 | Professional | 55 · Aftercare only | $575.44 | $575.44 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $389.05 Typical High $467.74 | Professional | 56 · Pre-op care only | $389.05 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $2,691.53 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $2,691.53 | $2,691.53 | $3,235.94 |
Where Colorado sits
The same service costs 21.4 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
$6,457
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.