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 $2,187.76 Median $3,981.07 Typical High $10,964.78 | Facility | None | $2,187.76 | $3,981.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,202.26 | $1,548.82 | $2,570.40 |
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 $1,445.44 Median $2,187.76 Typical High $3,388.44 | Professional | None | $1,445.44 | $2,187.76 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $3,801.89 Typical High $5,754.40 | Facility | None | $933.25 | $3,801.89 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,819.70 | $2,630.27 |
Denver HMP Setting Facility Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $2,691.53 | Facility | None | $1,202.26 | $1,698.24 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,819.70 | $2,818.38 |
Select Health Setting Facility Modifier None Typical Low $1,659.59 Median $3,090.30 Typical High $5,011.87 | Facility | None | $1,659.59 | $3,090.30 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $741.31 Median $1,659.59 Typical High $3,235.94 | Professional | None | $741.31 | $1,659.59 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,318.26 | $1,862.09 | $3,019.95 |
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 $602.56 Median $758.58 Typical High $776.25 | Professional | 52 · Reduced service | $602.56 | $758.58 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $239.88 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,148.15 Typical High $1,174.90 | Professional | 54 · Surgery only | $912.01 | $1,148.15 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $229.09 Typical High $234.42 | Professional | 55 · Aftercare only | $181.97 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $120.23 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,071.52 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $851.14 | $1,071.52 | $1,096.48 |
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· 10th of 51
$2,344
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.