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 $10,964.78 | Facility | None | $2,570.40 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $6,025.60 | Professional | None | $1,202.26 | $1,202.26 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $11,481.54 Median $16,982.44 Typical High $38,904.51 | Facility | None | $11,481.54 | $16,982.44 | $38,904.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,513.56 | $2,187.76 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,981.07 Typical High $6,165.95 | Facility | None | $758.58 | $3,981.07 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,862.09 | $2,570.40 |
Denver HMP Setting Facility Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $2,290.87 | Facility | None | $1,202.26 | $1,698.24 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,621.81 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $1,148.15 Median $2,290.87 Typical High $5,370.32 | Facility | None | $1,148.15 | $2,290.87 | $5,370.32 |
Select Health Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $2,238.72 | Professional | None | $794.33 | $1,148.15 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,479.11 | $1,905.46 | $3,019.95 |
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 $602.56 Median $602.56 Typical High $724.44 | Professional | 52 · Reduced service | $602.56 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $288.40 | Professional | 53 · Discontinued | $239.88 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,096.48 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $218.78 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $1,023.29 |
Where Colorado sits
The same service costs 6.9 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· 10th of 51
$2,570
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.