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 $2,137.96 Median $2,187.76 Typical High $6,025.60 | Professional | None | $2,137.96 | $2,187.76 | $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 $2,137.96 Median $2,818.38 Typical High $4,365.16 | Professional | None | $2,137.96 | $2,818.38 | $4,365.16 |
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 $2,137.96 Median $2,951.21 Typical High $3,981.07 | Professional | None | $2,137.96 | $2,951.21 | $3,981.07 |
Denver HMP Setting Facility Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $4,570.88 | Facility | None | $2,187.76 | $2,754.23 | $4,570.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $3,801.89 | Professional | None | $1,737.80 | $2,570.40 | $3,801.89 |
Select Health Setting Facility Modifier None Typical Low $1,819.70 Median $3,630.78 Typical High $3,801.89 | Facility | None | $1,819.70 | $3,630.78 | $3,801.89 |
Select Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,288.25 | $1,819.70 |
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 $2,290.87 Median $3,019.95 Typical High $4,897.79 | Professional | None | $2,290.87 | $3,019.95 | $4,897.79 |
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 $1,071.52 Median $1,096.48 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,071.52 | $1,096.48 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $436.52 Typical High $588.84 | Professional | 53 · Discontinued | $426.58 | $436.52 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,659.59 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,584.89 | $1,659.59 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $331.13 Typical High $436.52 | Professional | 55 · Aftercare only | $316.23 | $331.13 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $218.78 Typical High $295.12 | Professional | 56 · Pre-op care only | $213.80 | $218.78 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,548.82 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,548.82 | $2,041.74 |
Where Colorado sits
The same service costs 6.0 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
$3,311
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.