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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,047.13 | Professional | None | $741.31 | $741.31 | $1,047.13 |
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 $851.14 Median $1,202.26 Typical High $1,819.70 | Professional | None | $851.14 | $1,202.26 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,466.84 Typical High $7,079.46 | Facility | None | $691.83 | $4,466.84 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,318.26 | Professional | None | $758.58 | $912.01 | $1,318.26 |
Denver HMP Setting Facility Modifier None Typical Low $741.31 Median $954.99 Typical High $1,584.89 | Facility | None | $741.31 | $954.99 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,412.54 | Professional | None | $707.95 | $933.25 | $1,412.54 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $1,412.54 Typical High $6,165.95 | Facility | None | $707.95 | $1,412.54 | $6,165.95 |
Select Health Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,047.13 | Professional | None | $707.95 | $776.25 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,513.56 | Professional | None | $707.95 | $954.99 | $1,513.56 |
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 $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $524.81 |
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· 13th of 51
$1,230
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.