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 $1,023.29 Median $3,235.94 Typical High $8,912.51 | Facility | None | $1,023.29 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,348.96 | Professional | None | $831.76 | $1,023.29 | $1,348.96 |
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 $954.99 Median $1,348.96 Typical High $2,238.72 | Professional | None | $954.99 | $1,348.96 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,659.59 Typical High $2,691.53 | Facility | None | $691.83 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,513.56 | Professional | None | $912.01 | $1,096.48 | $1,513.56 |
Denver HMP Setting Facility Modifier None Typical Low $831.76 Median $1,202.26 Typical High $1,513.56 | Facility | None | $831.76 | $1,202.26 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $1,202.26 Typical High $1,778.28 | Professional | None | $741.31 | $1,202.26 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,737.80 Typical High $2,187.76 | Facility | None | $1,023.29 | $1,737.80 | $2,187.76 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $891.25 Typical High $1,023.29 | Professional | None | $501.19 | $891.25 | $1,023.29 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,905.46 | Professional | None | $891.25 | $1,174.90 | $1,905.46 |
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 $407.38 Median $446.68 Typical High $512.86 | Professional | 52 · Reduced service | $407.38 | $446.68 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $177.83 Typical High $204.17 | Professional | 53 · Discontinued | $165.96 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $676.08 Typical High $776.25 | Professional | 54 · Surgery only | $616.60 | $676.08 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $134.90 Typical High $154.88 | Professional | 55 · Aftercare only | $123.03 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $89.13 Typical High $102.33 | Professional | 56 · Pre-op care only | $81.28 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $630.96 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $575.44 | $630.96 | $724.44 |
Where Colorado sits
The same service costs 4.5 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
$1,288
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.