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 $1,479.11 Median $3,715.35 Typical High $10,715.19 | Facility | None | $1,479.11 | $3,715.35 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,479.11 | Professional | None | $630.96 | $851.14 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,318.26 Typical High $2,137.96 | Professional | None | $851.14 | $1,318.26 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,630.78 Typical High $5,754.40 | Facility | None | $691.83 | $3,630.78 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $1,548.82 | Professional | None | $707.95 | $1,023.29 | $1,548.82 |
Denver HMP Setting Facility Modifier None Typical Low $630.96 Median $891.25 Typical High $1,412.54 | Facility | None | $630.96 | $891.25 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $954.99 Typical High $1,513.56 | Professional | None | $602.56 | $954.99 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $1,584.89 Typical High $5,011.87 | Facility | None | $870.96 | $1,584.89 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $389.05 Median $870.96 Typical High $1,698.24 | Professional | None | $389.05 | $870.96 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $1,862.09 | Professional | None | $758.58 | $1,096.48 | $1,862.09 |
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 $316.23 Median $426.58 Typical High $478.63 | Professional | 52 · Reduced service | $316.23 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $169.82 Typical High $190.55 | Professional | 53 · Discontinued | $125.89 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $645.65 Typical High $707.95 | Professional | 54 · Surgery only | $467.74 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $128.82 Typical High $141.25 | Professional | 55 · Aftercare only | $93.33 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $85.11 Typical High $95.50 | Professional | 56 · Pre-op care only | $63.10 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $602.56 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $436.52 | $602.56 | $660.69 |
Where Colorado sits
The same service costs 5.2 times more in Alaska than in Utah. 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· 9th of 51
$1,380
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.