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 $616.60 Median $616.60 Typical High $741.31 | Professional | None | $616.60 | $616.60 | $741.31 |
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 $707.95 Median $977.24 Typical High $1,479.11 | Professional | None | $707.95 | $977.24 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,318.26 Typical High $2,691.53 | Facility | None | $691.83 | $1,318.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,148.15 | Professional | None | $630.96 | $776.25 | $1,148.15 |
Denver HMP Setting Facility Modifier None Typical Low $616.60 Median $851.14 Typical High $1,318.26 | Facility | None | $616.60 | $851.14 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,148.15 | Professional | None | $575.44 | $776.25 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $1,445.44 | Facility | None | $575.44 | $1,148.15 | $1,445.44 |
Select Health Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $870.96 | Professional | None | $575.44 | $630.96 | $870.96 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,413.10 | Facility | None | $1,288.25 | $2,511.89 | $7,413.10 |
United Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,230.27 | Professional | None | $616.60 | $812.83 | $1,230.27 |
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 $302.00 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $426.58 |
Where Colorado sits
The same service costs 7.4 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· 18th 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.