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 $407.38 Median $407.38 Typical High $5,495.41 | Professional | None | $407.38 | $407.38 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $954.99 | Professional | None | $457.09 | $645.65 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $3,235.94 | Facility | None | $588.84 | $2,187.76 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $776.25 | Professional | None | $416.87 | $575.44 | $776.25 |
Denver HMP Setting Facility Modifier None Typical Low $407.38 Median $537.03 Typical High $933.25 | Facility | None | $407.38 | $537.03 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $776.25 | Professional | None | $371.54 | $524.81 | $776.25 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $741.31 Typical High $2,884.03 | Facility | None | $371.54 | $741.31 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $724.44 | Professional | None | $263.03 | $371.54 | $724.44 |
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 $457.09 Median $588.84 Typical High $912.01 | Professional | None | $457.09 | $588.84 | $912.01 |
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 $204.17 Median $204.17 Typical High $251.19 | Professional | 52 · Reduced service | $204.17 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $102.33 | Professional | 53 · Discontinued | $81.28 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $380.19 | Professional | 54 · Surgery only | $309.03 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $75.86 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $51.29 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $354.81 |
Where Colorado sits
The same service costs 6.2 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· 10th of 51
$813
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.