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 $12,589.25 | Facility | None | $2,570.40 | $5,495.41 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,041.74 | Professional | None | $1,584.89 | $1,584.89 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,819.70 Median $2,570.40 Typical High $3,890.45 | Professional | None | $1,819.70 | $2,570.40 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $11,481.54 Typical High $18,197.01 | Facility | None | $812.83 | $11,481.54 | $18,197.01 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,621.81 | $1,949.84 | $2,754.23 |
Denver HMP Setting Facility Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $3,311.31 | Facility | None | $1,584.89 | $2,041.74 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,445.44 | $1,905.46 | $2,884.03 |
Select Health Setting Facility Modifier None Typical Low $1,445.44 Median $3,019.95 Typical High $15,848.93 | Facility | None | $1,445.44 | $3,019.95 | $15,848.93 |
Select Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $2,137.96 | Professional | None | $1,445.44 | $1,659.59 | $2,137.96 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $10,000.00 Typical High $22,387.21 | Facility | None | $4,570.88 | $10,000.00 | $22,387.21 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $3,235.94 | Professional | None | $1,584.89 | $2,089.30 | $3,235.94 |
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 $794.33 Median $794.33 Typical High $812.83 | Professional | 52 · Reduced service | $794.33 | $794.33 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $323.59 | Professional | 53 · Discontinued | $316.23 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $162.18 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,122.02 |
Where Colorado sits
The same service costs 20.0 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
$2,630
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.