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 $354.81 Median $3,090.30 Typical High $8,912.51 | Facility | None | $354.81 | $3,090.30 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $616.60 | Professional | None | $263.03 | $389.05 | $616.60 |
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 $288.40 Median $457.09 Typical High $758.58 | Professional | None | $288.40 | $457.09 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,445.44 Typical High $2,187.76 | Facility | None | $588.84 | $1,445.44 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $446.68 Typical High $630.96 | Professional | None | $275.42 | $446.68 | $630.96 |
Denver HMP Setting Facility Modifier None Typical Low $269.15 Median $389.05 Typical High $660.69 | Facility | None | $269.15 | $389.05 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $616.60 | Professional | None | $245.47 | $389.05 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $660.69 Typical High $1,659.59 | Facility | None | $363.08 | $660.69 | $1,659.59 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $363.08 Typical High $707.95 | Professional | None | $154.88 | $363.08 | $707.95 |
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 $275.42 Median $446.68 Typical High $724.44 | Professional | None | $275.42 | $446.68 | $724.44 |
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 $134.90 Median $165.96 Typical High $194.98 | Professional | 52 · Reduced service | $134.90 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $67.61 Typical High $77.62 | Professional | 53 · Discontinued | $53.70 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $251.19 Typical High $288.40 | Professional | 54 · Surgery only | $199.53 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $50.12 Typical High $57.54 | Professional | 55 · Aftercare only | $39.81 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $33.11 Typical High $38.90 | Professional | 56 · Pre-op care only | $26.92 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $234.42 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $186.21 | $234.42 | $269.15 |
Where Colorado sits
The same service costs 4.6 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· 15th of 51
$501
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.