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 $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,258.93 | Professional | None | $1,230.27 | $1,230.27 | $1,258.93 |
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 $1,412.54 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,412.54 | $2,041.74 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,786.30 Typical High $7,413.10 | Facility | None | $758.58 | $4,786.30 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,258.93 | $1,513.56 | $2,137.96 |
Denver HMP Setting Facility Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,570.40 | Facility | None | $1,230.27 | $1,584.89 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,513.56 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $1,122.02 Median $2,238.72 Typical High $6,456.54 | Facility | None | $1,122.02 | $2,238.72 | $6,456.54 |
Select Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,288.25 | $1,698.24 |
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 $1,202.26 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,584.89 | $2,511.89 |
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 $616.60 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $125.89 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $870.96 |
Where Colorado sits
The same service costs 16.2 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· 13th of 51
$1,995
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.