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 $10,964.78 | Facility | None | $2,570.40 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,621.81 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $3,388.44 | Professional | None | $1,513.56 | $1,995.26 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,454.71 Typical High $3,801.89 | Facility | None | $933.25 | $2,454.71 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,513.56 | $2,290.87 |
Denver HMP Setting Facility Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $3,090.30 | Facility | None | $1,348.96 | $1,621.81 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,258.93 | $1,621.81 | $2,454.71 |
Select Health Setting Facility Modifier None Typical Low $1,258.93 Median $2,511.89 Typical High $2,884.03 | Facility | None | $1,258.93 | $2,511.89 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $870.96 Median $1,348.96 Typical High $1,819.70 | Professional | None | $870.96 | $1,348.96 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $2,754.23 | Professional | None | $1,148.15 | $1,584.89 | $2,754.23 |
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 $660.69 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $660.69 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $263.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,000.00 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $199.53 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $131.83 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $933.25 | $1,148.15 | $1,148.15 |
Where Colorado sits
The same service costs 7.4 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
$2,344
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.