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 $1,584.89 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,584.89 | $1,584.89 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $2,630.27 Typical High $3,890.45 | Professional | None | $1,862.09 | $2,630.27 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,905.46 | $3,311.31 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,344.23 Typical High $3,162.28 | Professional | None | $1,621.81 | $2,344.23 | $3,162.28 |
Denver HMP Setting Facility Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $3,890.45 | Facility | None | $1,584.89 | $1,995.26 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,548.82 | $2,187.76 | $3,235.94 |
Select Health Setting Facility Modifier None Typical Low $1,548.82 Median $3,090.30 Typical High $3,630.78 | Facility | None | $1,548.82 | $3,090.30 | $3,630.78 |
Select Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $3,019.95 | Professional | None | $1,096.48 | $1,548.82 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,290.87 Typical High $3,715.35 | Professional | None | $1,659.59 | $2,290.87 | $3,715.35 |
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 $794.33 Median $794.33 Typical High $933.25 | Professional | 52 · Reduced service | $794.33 | $794.33 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $380.19 | Professional | 53 · Discontinued | $316.23 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $281.84 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $190.55 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,318.26 |
Where Colorado sits
The same service costs 6.6 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· 11th of 51
$3,020
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.