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 $1,202.26 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,445.44 | $2,344.23 |
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 $1,318.26 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,318.26 | $1,737.80 | $3,019.95 |
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 $977.24 Median $1,348.96 Typical High $1,949.84 | Professional | None | $977.24 | $1,348.96 | $1,949.84 |
Denver HMP Setting Facility Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,691.53 | Facility | None | $1,202.26 | $1,445.44 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,412.54 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $1,096.48 Median $2,187.76 Typical High $2,884.03 | Facility | None | $1,096.48 | $2,187.76 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,584.89 | Professional | None | $758.58 | $1,202.26 | $1,584.89 |
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 $1,000.00 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,000.00 | $1,412.54 | $2,398.83 |
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 $588.84 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $588.84 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $234.42 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $891.25 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $177.83 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $117.49 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $831.76 | $1,000.00 | $1,000.00 |
Where Colorado sits
The same service costs 7.6 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· 14th of 51
$2,089
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.