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 $645.65 Median $812.83 Typical High $812.83 | Professional | None | $645.65 | $812.83 | $812.83 |
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 $741.31 Median $1,047.13 Typical High $1,584.89 | Professional | None | $741.31 | $1,047.13 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,230.27 Typical High $5,248.07 | Facility | None | $831.76 | $1,230.27 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,348.96 | Professional | None | $691.83 | $912.01 | $1,348.96 |
Denver HMP Setting Facility Modifier None Typical Low $645.65 Median $933.25 Typical High $1,318.26 | Facility | None | $645.65 | $933.25 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $1,412.54 | Professional | None | $691.83 | $977.24 | $1,412.54 |
Select Health Setting Facility Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,737.80 | Facility | None | $831.76 | $1,096.48 | $1,737.80 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $870.96 | Professional | None | $645.65 | $758.58 | $870.96 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,548.82 | Professional | None | $676.08 | $912.01 | $1,548.82 |
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 $323.59 Median $398.11 Typical High $407.38 | Professional | 52 · Reduced service | $323.59 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $158.49 Typical High $162.18 | Professional | 53 · Discontinued | $128.82 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $588.84 Typical High $602.56 | Professional | 54 · Surgery only | $489.78 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $117.49 Typical High $123.03 | Professional | 55 · Aftercare only | $97.72 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $79.43 Typical High $81.28 | Professional | 56 · Pre-op care only | $64.57 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $549.54 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $457.09 | $549.54 | $562.34 |
Where Colorado sits
The same service costs 5.6 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· 17th of 51
$1,000
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.