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 $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,096.48 | $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 $1,258.93 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,737.80 | $2,570.40 |
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 $1,122.02 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,548.82 | $2,089.30 |
Denver HMP Setting Facility Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,570.40 | Facility | None | $1,096.48 | $1,380.38 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,445.44 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $1,023.29 Median $2,041.74 Typical High $2,137.96 | Facility | None | $1,023.29 | $2,041.74 | $2,137.96 |
Select Health Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $1,995.26 | Professional | None | $707.95 | $1,023.29 | $1,995.26 |
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 $1,148.15 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,548.82 | $2,511.89 |
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 $549.54 Median $549.54 Typical High $676.08 | Professional | 52 · Reduced service | $549.54 | $549.54 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $275.42 | Professional | 53 · Discontinued | $218.78 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,023.29 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $204.17 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $138.04 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $954.99 |
Where Colorado sits
The same service costs 6.6 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
$1,950
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.