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 $1,513.56 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,513.56 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $4,466.84 | Professional | None | $1,047.13 | $1,047.13 | $4,466.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,174.90 | $1,659.59 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,548.82 Typical High $2,691.53 | Facility | None | $758.58 | $1,548.82 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,023.29 | $1,445.44 | $1,949.84 |
Denver HMP Setting Facility Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,290.87 | Facility | None | $1,047.13 | $1,348.96 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $2,041.74 | Professional | None | $933.25 | $1,288.25 | $2,041.74 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $1,659.59 Typical High $1,949.84 | Facility | None | $933.25 | $1,659.59 | $1,949.84 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,819.70 | Professional | None | $645.65 | $933.25 | $1,819.70 |
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 $1,174.90 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,174.90 | $1,445.44 | $2,344.23 |
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 $512.86 Median $512.86 Typical High $645.65 | Professional | 52 · Reduced service | $512.86 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $257.04 | Professional | 53 · Discontinued | $208.93 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $977.24 | Professional | 54 · Surgery only | $776.25 | $776.25 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $194.98 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $128.82 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $912.01 |
Where Colorado sits
The same service costs 5.9 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· 11th of 51
$1,862
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.