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 $1,258.93 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,096.48 | Professional | None | $724.44 | $851.14 | $1,096.48 |
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 $831.76 Median $1,174.90 Typical High $1,949.84 | Professional | None | $831.76 | $1,174.90 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,862.09 Typical High $2,691.53 | Facility | None | $758.58 | $1,862.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,288.25 | Professional | None | $707.95 | $912.01 | $1,288.25 |
Denver HMP Setting Facility Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,348.96 | Facility | None | $741.31 | $1,000.00 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $1,148.15 Typical High $1,621.81 | Professional | None | $707.95 | $1,148.15 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $1,778.28 Typical High $2,089.30 | Facility | None | $954.99 | $1,778.28 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $831.76 Typical High $954.99 | Professional | None | $467.74 | $831.76 | $954.99 |
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 $776.25 Median $977.24 Typical High $1,621.81 | Professional | None | $776.25 | $977.24 | $1,621.81 |
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 $363.08 Median $389.05 Typical High $446.68 | Professional | 52 · Reduced service | $363.08 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $158.49 Typical High $177.83 | Professional | 53 · Discontinued | $144.54 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $588.84 Typical High $676.08 | Professional | 54 · Surgery only | $537.03 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $117.49 Typical High $134.90 | Professional | 55 · Aftercare only | $107.15 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $77.62 Typical High $89.13 | Professional | 56 · Pre-op care only | $72.44 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $549.54 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $501.19 | $549.54 | $630.96 |
Where Colorado sits
The same service costs 4.9 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
$1,175
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.