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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,288.25 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $2,630.27 | Professional | None | $1,174.90 | $1,548.82 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,819.70 Typical High $2,691.53 | Facility | None | $691.83 | $1,819.70 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,737.80 | Professional | None | $912.01 | $1,230.27 | $1,737.80 |
Denver HMP Setting Facility Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $2,344.23 | Facility | None | $1,096.48 | $1,318.26 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,905.46 | Professional | None | $954.99 | $1,230.27 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $1,905.46 Typical High $2,089.30 | Facility | None | $954.99 | $1,905.46 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $1,071.52 Typical High $1,380.38 | Professional | None | $660.69 | $1,071.52 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,182.57 | Facility | None | $1,949.84 | $4,265.80 | $13,182.57 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $2,137.96 | Professional | None | $954.99 | $1,318.26 | $2,137.96 |
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 $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $537.03 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $213.80 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $794.33 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $158.49 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $107.15 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $741.31 | $891.25 | $891.25 |
Where Colorado sits
The same service costs 7.6 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· 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.