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 $1,202.26 Median $1,202.26 Typical High $1,318.26 | Professional | None | $1,202.26 | $1,202.26 | $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 $1,412.54 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,412.54 | $2,041.74 | $3,019.95 |
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 $1,230.27 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,479.11 | $2,187.76 |
Denver HMP Setting Facility Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,884.03 | Facility | None | $1,202.26 | $1,513.56 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,513.56 | $2,290.87 |
Select Health Setting Facility Modifier None Typical Low $1,148.15 Median $2,290.87 Typical High $2,398.83 | Facility | None | $1,148.15 | $2,290.87 | $2,398.83 |
Select Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,288.25 | $1,698.24 |
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 $1,202.26 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,621.81 | $2,511.89 |
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 $602.56 Median $602.56 Typical High $630.96 | Professional | 52 · Reduced service | $602.56 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $251.19 | Professional | 53 · Discontinued | $245.47 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $954.99 | Professional | 54 · Surgery only | $912.01 | $912.01 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $190.55 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $125.89 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $891.25 |
Where Colorado sits
The same service costs 6.5 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· 13th of 51
$1,905
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.