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 $1,000.00 Median $1,000.00 Typical High $1,288.25 | Professional | None | $1,000.00 | $1,000.00 | $1,288.25 |
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 $1,122.02 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,621.81 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,290.87 Typical High $3,090.30 | Facility | None | $691.83 | $2,290.87 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,288.25 | $1,778.28 |
Denver HMP Setting Facility Modifier None Typical Low $977.24 Median $1,258.93 Typical High $2,137.96 | Facility | None | $977.24 | $1,258.93 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,819.70 | Professional | None | $912.01 | $1,230.27 | $1,819.70 |
Select Health Setting Facility Modifier None Typical Low $912.01 Median $1,819.70 Typical High $2,754.23 | Facility | None | $912.01 | $1,819.70 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,380.38 | Professional | None | $912.01 | $1,023.29 | $1,380.38 |
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 $912.01 Median $1,288.25 Typical High $2,041.74 | Professional | None | $912.01 | $1,288.25 | $2,041.74 |
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 $489.78 Median $489.78 Typical High $501.19 | Professional | 52 · Reduced service | $489.78 | $489.78 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $758.58 | Professional | 54 · Surgery only | $741.31 | $741.31 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $151.36 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $707.95 |
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· 12th of 51
$1,622
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.