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 $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,584.89 | $1,698.24 | $2,570.40 |
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 $1,659.59 Median $2,344.23 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,344.23 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,344.23 Typical High $4,786.30 | Facility | None | $676.08 | $2,344.23 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,548.82 | $2,041.74 | $2,691.53 |
Denver HMP Setting Facility Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $3,090.30 | Facility | None | $1,659.59 | $1,949.84 | $3,090.30 |
Kaiser Permanente 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 |
Select Health Setting Facility Modifier None Typical Low $1,230.27 Median $2,454.71 Typical High $2,570.40 | Facility | None | $1,230.27 | $2,454.71 | $2,570.40 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $2,398.83 | Professional | None | $851.14 | $1,230.27 | $2,398.83 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,584.89 | $2,041.74 | $3,162.28 |
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 $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $794.33 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $316.23 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,202.26 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $239.88 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $158.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,174.90 | $1,174.90 |
Where Colorado sits
The same service costs 7.8 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· 10th of 51
$2,512
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.