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 $1,023.29 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,023.29 | $1,258.93 | $2,041.74 |
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 $1,148.15 Median $1,513.56 Typical High $2,570.40 | Professional | None | $1,148.15 | $1,513.56 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,454.71 Typical High $3,311.31 | Facility | None | $691.83 | $2,454.71 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,698.24 | Professional | None | $870.96 | $1,148.15 | $1,698.24 |
Denver HMP Setting Facility Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $2,344.23 | Facility | None | $1,000.00 | $1,258.93 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,862.09 | Professional | None | $954.99 | $1,230.27 | $1,862.09 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $1,905.46 Typical High $2,884.03 | Facility | None | $954.99 | $1,905.46 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $1,047.13 Typical High $1,380.38 | Professional | None | $660.69 | $1,047.13 | $1,380.38 |
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 $891.25 Median $1,230.27 Typical High $2,089.30 | Professional | None | $891.25 | $1,230.27 | $2,089.30 |
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 $501.19 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $501.19 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $204.17 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $758.58 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $151.36 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $102.33 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $707.95 | $870.96 | $870.96 |
Where Colorado sits
The same service costs 7.2 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· 14th of 51
$1,820
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.