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 $1,071.52 Median $1,071.52 Typical High $1,202.26 | Professional | None | $1,071.52 | $1,071.52 | $1,202.26 |
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 $1,202.26 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,202.26 | $1,778.28 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $1,862.09 | Professional | None | $851.14 | $1,230.27 | $1,862.09 |
Denver HMP Setting Facility Modifier None Typical Low $977.24 Median $1,174.90 Typical High $2,691.53 | Facility | None | $977.24 | $1,174.90 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,445.44 | $2,187.76 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $2,187.76 Typical High $2,290.87 | Facility | None | $1,071.52 | $2,187.76 | $2,290.87 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,122.02 | $1,621.81 |
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 $870.96 Median $1,288.25 Typical High $2,238.72 | Professional | None | $870.96 | $1,288.25 | $2,238.72 |
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 $537.03 Median $537.03 Typical High $549.54 | Professional | 52 · Reduced service | $537.03 | $537.03 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $218.78 | Professional | 53 · Discontinued | $213.80 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $831.76 | Professional | 54 · Surgery only | $794.33 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $165.96 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $109.65 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $776.25 |
Where Colorado sits
The same service costs 21.9 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· 14th of 51
$1,660
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.