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 $6,165.95 Typical High $12,022.64 | Facility | None | $2,570.40 | $6,165.95 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $5,754.40 | Professional | None | $1,548.82 | $1,621.81 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $7,585.78 Typical High $13,182.57 | Facility | None | $2,344.23 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $3,235.94 | Professional | None | $1,513.56 | $2,041.74 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,445.44 | $2,041.74 | $2,754.23 |
Denver HMP Setting Facility Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $3,235.94 | Facility | None | $1,445.44 | $1,778.28 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,230.27 | $1,862.09 | $2,754.23 |
Select Health Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $2,754.23 | Facility | None | $1,318.26 | $2,630.27 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,318.26 | Professional | None | $912.01 | $912.01 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,762.47 | Facility | None | $1,288.25 | $2,511.89 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,513.56 | $2,187.76 | $3,467.37 |
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 $776.25 Median $812.83 Typical High $1,047.13 | Professional | 52 · Reduced service | $776.25 | $812.83 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $323.59 Typical High $416.87 | Professional | 53 · Discontinued | $309.03 | $323.59 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,202.26 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,148.15 | $1,202.26 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $239.88 Typical High $316.23 | Professional | 55 · Aftercare only | $229.09 | $239.88 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $162.18 Typical High $208.93 | Professional | 56 · Pre-op care only | $154.88 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,122.02 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,122.02 | $1,479.11 |
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· 11th of 51
$2,630
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.