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 $1,122.02 Median $1,122.02 Typical High $6,025.60 | Professional | None | $1,122.02 | $1,122.02 | $6,025.60 |
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 $1,412.54 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,412.54 | $1,995.26 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,754.23 Typical High $4,365.16 | Facility | None | $758.58 | $2,754.23 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,737.80 | $2,398.83 |
Denver HMP Setting Facility Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $2,137.96 | Facility | None | $1,122.02 | $1,548.82 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,513.56 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $3,801.89 | Facility | None | $1,071.52 | $2,137.96 | $3,801.89 |
Select Health Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $2,089.30 | Professional | None | $741.31 | $1,071.52 | $2,089.30 |
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 $1,380.38 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,380.38 | $1,778.28 | $2,818.38 |
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 $676.08 | Professional | 52 · Reduced service | $562.34 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $269.15 | Professional | 53 · Discontinued | $223.87 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,000.00 |
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 $112.20 Median $112.20 Typical High $134.90 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $933.25 |
Where Colorado sits
The same service costs 7.2 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· 8th of 51
$2,399
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.