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 $2,691.53 Median $5,495.41 Typical High $12,882.50 | Facility | None | $2,691.53 | $5,495.41 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,096.48 | Professional | None | $851.14 | $851.14 | $1,096.48 |
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 $977.24 Median $1,380.38 Typical High $2,089.30 | Professional | None | $977.24 | $1,380.38 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $5,248.07 Typical High $9,549.93 | Facility | None | $1,318.26 | $5,248.07 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,548.82 | Professional | None | $870.96 | $1,071.52 | $1,548.82 |
Denver HMP Setting Facility Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,778.28 | Facility | None | $851.14 | $1,096.48 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,548.82 | Professional | None | $776.25 | $1,023.29 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $776.25 Median $1,548.82 Typical High $8,317.64 | Facility | None | $776.25 | $1,548.82 | $8,317.64 |
Select Health Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,174.90 | Professional | None | $776.25 | $891.25 | $1,174.90 |
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 $831.76 Median $1,122.02 Typical High $1,819.70 | Professional | None | $831.76 | $1,122.02 | $1,819.70 |
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 $426.58 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | 53 · Discontinued | $169.82 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $602.56 |
Where Colorado sits
The same service costs 17.8 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
$1,413
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.