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 $851.14 Median $912.01 Typical High $5,495.41 | Professional | None | $851.14 | $912.01 | $5,495.41 |
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 $933.25 Median $1,258.93 Typical High $2,187.76 | Professional | None | $933.25 | $1,258.93 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,778.28 Typical High $2,691.53 | Facility | None | $691.83 | $1,778.28 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,412.54 | Professional | None | $851.14 | $1,071.52 | $1,412.54 |
Denver HMP Setting Facility Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,318.26 | Facility | None | $912.01 | $1,096.48 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,621.81 | Professional | None | $831.76 | $1,122.02 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $831.76 Median $1,659.59 Typical High $2,089.30 | Facility | None | $831.76 | $1,659.59 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $1,148.15 | Professional | None | $575.44 | $831.76 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,778.28 | Professional | None | $933.25 | $1,096.48 | $1,778.28 |
7 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 $416.87 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $416.87 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $165.96 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $616.60 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $123.03 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $83.18 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $575.44 | $645.65 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,258.93 Typical High $1,778.28 | Professional | 50 · Both sides | $851.14 | $1,258.93 | $1,778.28 |
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· 13th of 51
$1,514
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.