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 $2,041.74 Median $2,290.87 Typical High $3,388.44 | Professional | None | $2,041.74 | $2,290.87 | $3,388.44 |
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 $2,187.76 Median $2,884.03 Typical High $4,570.88 | Professional | None | $2,187.76 | $2,884.03 | $4,570.88 |
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 $2,398.83 Median $3,090.30 Typical High $4,073.80 | Professional | None | $2,398.83 | $3,090.30 | $4,073.80 |
Denver HMP Setting Facility Modifier None Typical Low $2,290.87 Median $2,951.21 Typical High $4,677.35 | Facility | None | $2,290.87 | $2,951.21 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,630.27 Typical High $3,981.07 | Professional | None | $1,778.28 | $2,630.27 | $3,981.07 |
Select Health Setting Facility Modifier None Typical Low $1,862.09 Median $3,801.89 Typical High $3,981.07 | Facility | None | $1,862.09 | $3,801.89 | $3,981.07 |
Select Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,862.09 | Professional | None | $1,318.26 | $1,318.26 | $1,862.09 |
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 $2,454.71 Median $3,235.94 Typical High $5,128.61 | Professional | None | $2,454.71 | $3,235.94 | $5,128.61 |
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 $1,096.48 Median $1,148.15 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,096.48 | $1,148.15 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $457.09 Typical High $616.60 | Professional | 53 · Discontinued | $446.68 | $457.09 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,737.80 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,659.59 | $1,737.80 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $346.74 Typical High $457.09 | Professional | 55 · Aftercare only | $331.13 | $346.74 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $229.09 Typical High $309.03 | Professional | 56 · Pre-op care only | $218.78 | $229.09 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,621.81 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,621.81 | $2,137.96 |
Where Colorado sits
The same service costs 5.2 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· 13th of 51
$3,388
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.