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 $1,995.26 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $5,495.41 | Professional | None | $954.99 | $1,047.13 | $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 $1,047.13 Median $1,412.54 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,412.54 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,691.53 Typical High $3,715.35 | Facility | None | $831.76 | $2,691.53 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,584.89 | Professional | None | $977.24 | $1,202.26 | $1,584.89 |
Denver HMP Setting Facility Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,513.56 | Facility | None | $1,047.13 | $1,258.93 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,862.09 | Professional | None | $933.25 | $1,258.93 | $1,862.09 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $1,862.09 Typical High $3,235.94 | Facility | None | $933.25 | $1,862.09 | $3,235.94 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,288.25 | Professional | None | $645.65 | $933.25 | $1,288.25 |
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 $1,047.13 Median $1,230.27 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,230.27 | $1,995.26 |
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 $467.74 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $467.74 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $186.21 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $707.95 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $141.25 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $93.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $660.69 | $724.44 | $724.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $588.84 Typical High $891.25 | Professional | 62 · Two surgeons | $416.87 | $588.84 | $891.25 |
Where Colorado sits
The same service costs 8.3 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· 11th of 51
$1,862
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.