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 $2,630.27 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,630.27 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,630.27 Typical High $5,495.41 | Professional | None | $2,344.23 | $2,630.27 | $5,495.41 |
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 $2,511.89 Median $3,311.31 Typical High $5,248.07 | Professional | None | $2,511.89 | $3,311.31 | $5,248.07 |
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 $2,570.40 Median $3,467.37 Typical High $4,570.88 | Professional | None | $2,570.40 | $3,467.37 | $4,570.88 |
Denver HMP Setting Facility Modifier None Typical Low $2,630.27 Median $3,235.94 Typical High $5,370.32 | Facility | None | $2,630.27 | $3,235.94 | $5,370.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,041.74 Median $3,019.95 Typical High $4,570.88 | Professional | None | $2,041.74 | $3,019.95 | $4,570.88 |
Select Health Setting Facility Modifier None Typical Low $2,137.96 Median $4,365.16 Typical High $4,570.88 | Facility | None | $2,137.96 | $4,365.16 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,513.56 | $2,137.96 |
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 $2,754.23 Median $3,630.78 Typical High $5,888.44 | Professional | None | $2,754.23 | $3,630.78 | $5,888.44 |
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 $1,258.93 Median $1,318.26 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,258.93 | $1,318.26 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $524.81 Typical High $707.95 | Professional | 53 · Discontinued | $501.19 | $524.81 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,949.84 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,905.46 | $1,949.84 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $398.11 Typical High $524.81 | Professional | 55 · Aftercare only | $380.19 | $398.11 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $263.03 Typical High $346.74 | Professional | 56 · Pre-op care only | $251.19 | $263.03 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,819.70 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,819.70 | $2,454.71 |
Where Colorado sits
The same service costs 5.8 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· 13th of 51
$3,802
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.