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 $10,964.78 | Facility | None | $2,570.40 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,202.26 | Professional | None | $954.99 | $954.99 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $15,135.61 Typical High $25,703.96 | Facility | None | $10,000.00 | $15,135.61 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,548.82 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $4,570.88 Typical High $8,912.51 | Facility | None | $933.25 | $4,570.88 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,659.59 | Professional | None | $977.24 | $1,174.90 | $1,659.59 |
Denver HMP Setting Facility Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,995.26 | Facility | None | $954.99 | $1,230.27 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,737.80 | Professional | None | $870.96 | $1,174.90 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $1,737.80 Typical High $7,762.47 | Facility | None | $870.96 | $1,737.80 | $7,762.47 |
Select Health Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,318.26 | Professional | None | $870.96 | $1,000.00 | $1,318.26 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,949.84 | Professional | None | $954.99 | $1,230.27 | $1,949.84 |
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 $478.63 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $724.44 | Professional | 54 · Surgery only | $707.95 | $707.95 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $144.54 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $676.08 |
Where Colorado sits
The same service costs 7.9 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· 12th 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.