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 $2,570.40 Median $4,365.16 Typical High $11,748.98 | Facility | None | $2,570.40 | $4,365.16 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $724.44 | Professional | None | $537.03 | $645.65 | $724.44 |
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 $630.96 Median $870.96 Typical High $1,288.25 | Professional | None | $630.96 | $870.96 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,019.95 Typical High $5,248.07 | Facility | None | $1,318.26 | $3,019.95 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,174.90 | Professional | None | $660.69 | $831.76 | $1,174.90 |
Denver HMP Setting Facility Modifier None Typical Low $537.03 Median $831.76 Typical High $1,148.15 | Facility | None | $537.03 | $831.76 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,148.15 | Professional | None | $602.56 | $812.83 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $1,230.27 Typical High $3,548.13 | Facility | None | $676.08 | $1,230.27 | $3,548.13 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $741.31 | Professional | None | $537.03 | $645.65 | $741.31 |
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 $630.96 Median $851.14 Typical High $1,348.96 | Professional | None | $630.96 | $851.14 | $1,348.96 |
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 $269.15 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $269.15 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $107.15 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $407.38 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $81.28 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $53.70 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $380.19 | $446.68 | $446.68 |
Where Colorado sits
The same service costs 6.2 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· 20th of 51
$891
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.