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 $1,995.26 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,047.13 | $1,318.26 |
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 $1,258.93 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,778.28 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,311.31 Typical High $5,248.07 | Facility | None | $831.76 | $3,311.31 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,174.90 | $1,380.38 | $1,905.46 |
Denver HMP Setting Facility Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,398.83 | Facility | None | $1,047.13 | $1,348.96 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $1,949.84 | Professional | None | $954.99 | $1,288.25 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $1,905.46 Typical High $4,570.88 | Facility | None | $954.99 | $1,905.46 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,445.44 | Professional | None | $954.99 | $1,122.02 | $1,445.44 |
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 $1,122.02 Median $1,445.44 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,445.44 | $2,290.87 |
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 $524.81 Median $524.81 Typical High $549.54 | Professional | 52 · Reduced service | $524.81 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $218.78 | Professional | 53 · Discontinued | $208.93 | $208.93 | $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 $104.71 Median $104.71 Typical High $109.65 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $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 6.3 times more in Alaska than in Utah. 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
$1,778
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.