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 $1,148.15 Median $3,388.44 Typical High $8,709.64 | Facility | None | $1,148.15 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $630.96 | Professional | None | $512.86 | $512.86 | $630.96 |
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 $575.44 Median $831.76 Typical High $1,230.27 | Professional | None | $575.44 | $831.76 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,230.27 Typical High $1,659.59 | Facility | None | $436.52 | $1,230.27 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $870.96 | Professional | None | $478.63 | $588.84 | $870.96 |
Denver HMP Setting Facility Modifier None Typical Low $489.78 Median $616.60 Typical High $1,096.48 | Facility | None | $489.78 | $616.60 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $977.24 | Professional | None | $489.78 | $660.69 | $977.24 |
Select Health Setting Facility Modifier None Typical Low $489.78 Median $977.24 Typical High $1,445.44 | Facility | None | $489.78 | $977.24 | $1,445.44 |
Select Health Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $741.31 | Professional | None | $489.78 | $537.03 | $741.31 |
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 $457.09 Median $616.60 Typical High $1,000.00 | Professional | None | $457.09 | $616.60 | $1,000.00 |
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 $251.19 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $251.19 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $100.00 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $50.12 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $354.81 |
Where Colorado sits
The same service costs 7.6 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· 15th of 51
$813
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.