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 $2,691.53 Median $5,495.41 Typical High $12,882.50 | Facility | None | $2,691.53 | $5,495.41 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $3,388.44 | Professional | None | $1,148.15 | $1,202.26 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $11,220.18 Typical High $18,620.87 | Facility | None | $7,244.36 | $11,220.18 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,445.44 | $2,041.74 | $3,019.95 |
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 $1,318.26 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,318.26 | $1,778.28 | $2,454.71 |
Denver HMP Setting Facility Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $2,187.76 | Facility | None | $1,148.15 | $1,584.89 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,548.82 | $2,290.87 |
Select Health Setting Facility Modifier None Typical Low $1,096.48 Median $2,187.76 Typical High $2,290.87 | Facility | None | $1,096.48 | $2,187.76 | $2,290.87 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $2,137.96 | Professional | None | $758.58 | $1,096.48 | $2,137.96 |
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 $1,412.54 Median $1,819.70 Typical High $2,884.03 | Professional | None | $1,412.54 | $1,819.70 | $2,884.03 |
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 $562.34 Median $562.34 Typical High $691.83 | Professional | 52 · Reduced service | $562.34 | $562.34 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $281.84 | Professional | 53 · Discontinued | $229.09 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $1,047.13 | Professional | 54 · Surgery only | $851.14 | $851.14 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $208.93 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $138.04 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $977.24 |
Where Colorado sits
The same service costs 7.1 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· 9th of 51
$2,291
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.