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 $3,090.30 Median $5,495.41 Typical High $8,912.51 | Facility | None | $3,090.30 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $3,548.13 Typical High $5,248.07 | Professional | None | $3,162.28 | $3,548.13 | $5,248.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $11,481.54 Median $16,982.44 Typical High $38,904.51 | Facility | None | $11,481.54 | $16,982.44 | $38,904.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,388.44 Median $4,570.88 Typical High $7,244.36 | Professional | None | $3,388.44 | $4,570.88 | $7,244.36 |
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 $3,630.78 Median $4,786.30 Typical High $6,309.57 | Professional | None | $3,630.78 | $4,786.30 | $6,309.57 |
Denver HMP Setting Facility Modifier None Typical Low $3,548.13 Median $4,365.16 Typical High $7,413.10 | Facility | None | $3,548.13 | $4,365.16 | $7,413.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,818.38 Median $4,168.69 Typical High $6,309.57 | Professional | None | $2,818.38 | $4,168.69 | $6,309.57 |
Select Health Setting Facility Modifier None Typical Low $2,951.21 Median $5,888.44 Typical High $6,309.57 | Facility | None | $2,951.21 | $5,888.44 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,951.21 | Professional | None | $2,089.30 | $2,089.30 | $2,951.21 |
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 $3,715.35 Median $4,897.79 Typical High $8,128.31 | Professional | None | $3,715.35 | $4,897.79 | $8,128.31 |
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 $1,737.80 Median $1,778.28 Typical High $2,398.83 | Professional | 52 · Reduced service | $1,737.80 | $1,778.28 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $724.44 Typical High $954.99 | Professional | 53 · Discontinued | $691.83 | $724.44 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,691.53 Typical High $3,630.78 | Professional | 54 · Surgery only | $2,570.40 | $2,691.53 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $537.03 Typical High $724.44 | Professional | 55 · Aftercare only | $512.86 | $537.03 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $354.81 Typical High $478.63 | Professional | 56 · Pre-op care only | $346.74 | $354.81 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $2,511.89 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $2,398.83 | $2,511.89 | $3,388.44 |
Where Colorado sits
The same service costs 6.3 times more in Alaska than in Arkansas. 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
$5,129
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.