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 $741.31 Median $1,548.82 Typical High $1,659.59 | Professional | None | $741.31 | $1,548.82 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,778.28 | Professional | None | $870.96 | $1,202.26 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $4,168.69 Typical High $5,754.40 | Facility | None | $1,318.26 | $4,168.69 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,621.81 Typical High $2,754.23 | Professional | None | $891.25 | $1,621.81 | $2,754.23 |
Denver HMP Setting Facility Modifier None Typical Low $741.31 Median $1,659.59 Typical High $2,511.89 | Facility | None | $741.31 | $1,659.59 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,513.56 Typical High $2,754.23 | Professional | None | $812.83 | $1,513.56 | $2,754.23 |
Select Health Setting Facility Modifier None Typical Low $1,348.96 Median $3,235.94 Typical High $5,011.87 | Facility | None | $1,348.96 | $3,235.94 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,737.80 | Professional | None | $741.31 | $891.25 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,698.24 Typical High $3,019.95 | Professional | None | $851.14 | $1,698.24 | $3,019.95 |
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 $371.54 Median $645.65 Typical High $831.76 | Professional | 52 · Reduced service | $371.54 | $645.65 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $257.04 Typical High $331.13 | Professional | 53 · Discontinued | $147.91 | $257.04 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $954.99 Typical High $1,230.27 | Professional | 54 · Surgery only | $562.34 | $954.99 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $190.55 Typical High $245.47 | Professional | 55 · Aftercare only | $112.20 | $190.55 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $128.82 Typical High $165.96 | Professional | 56 · Pre-op care only | $74.13 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $891.25 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $524.81 | $891.25 | $1,148.15 |
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· 27th of 51
$1,549
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.