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 $10,964.78 | Facility | None | $2,570.40 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $4,265.80 | Professional | None | $1,348.96 | $1,584.89 | $4,265.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $2,238.72 Typical High $3,388.44 | Professional | None | $1,584.89 | $2,238.72 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $3,801.89 Typical High $5,754.40 | Facility | None | $933.25 | $3,801.89 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,737.80 | $2,570.40 |
Denver HMP Setting Facility Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $3,311.31 | Facility | None | $1,412.54 | $1,659.59 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,318.26 | $1,862.09 | $2,818.38 |
Select Health Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $5,011.87 | Facility | None | $1,318.26 | $2,630.27 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $2,570.40 | Professional | None | $933.25 | $1,318.26 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,348.96 | $1,819.70 | $3,019.95 |
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 $691.83 Median $794.33 Typical High $812.83 | Professional | 52 · Reduced service | $691.83 | $794.33 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $316.23 Typical High $323.59 | Professional | 53 · Discontinued | $275.42 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,202.26 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,047.13 | $1,202.26 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $239.88 Typical High $245.47 | Professional | 55 · Aftercare only | $208.93 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $158.49 Typical High $162.18 | Professional | 56 · Pre-op care only | $138.04 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,122.02 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $977.24 | $1,122.02 | $1,148.15 |
Where Colorado sits
The same service costs 5.9 times more in Alaska than in Utah. 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· 8th of 51
$2,692
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.