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 $1,905.46 Median $1,949.84 Typical High $6,025.60 | Professional | None | $1,905.46 | $1,949.84 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,715.19 Median $13,182.57 Typical High $24,547.09 | Facility | None | $10,715.19 | $13,182.57 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $2,511.89 Typical High $3,890.45 | Professional | None | $1,905.46 | $2,511.89 | $3,890.45 |
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 $1,995.26 Median $2,630.27 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,630.27 | $3,548.13 |
Denver HMP Setting Facility Modifier None Typical Low $1,949.84 Median $2,511.89 Typical High $4,168.69 | Facility | None | $1,949.84 | $2,511.89 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $2,344.23 Typical High $3,467.37 | Professional | None | $1,548.82 | $2,344.23 | $3,467.37 |
Select Health Setting Facility Modifier None Typical Low $1,659.59 Median $3,311.31 Typical High $3,467.37 | Facility | None | $1,659.59 | $3,311.31 | $3,467.37 |
Select Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,148.15 | $1,659.59 |
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 $2,089.30 Median $2,691.53 Typical High $4,365.16 | Professional | None | $2,089.30 | $2,691.53 | $4,365.16 |
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 $933.25 Median $977.24 Typical High $1,318.26 | Professional | 52 · Reduced service | $933.25 | $977.24 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $389.05 Typical High $524.81 | Professional | 53 · Discontinued | $380.19 | $389.05 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,479.11 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,412.54 | $1,479.11 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $295.12 Typical High $389.05 | Professional | 55 · Aftercare only | $281.84 | $295.12 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $194.98 Typical High $263.03 | Professional | 56 · Pre-op care only | $190.55 | $194.98 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,380.38 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,380.38 | $1,819.70 |
Where Colorado sits
The same service costs 6.2 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· 11th of 51
$3,020
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.