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 $831.76 Median $831.76 Typical High $6,025.60 | Professional | None | $831.76 | $831.76 | $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 $1,071.52 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,513.56 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,778.28 | Professional | None | $954.99 | $1,318.26 | $1,778.28 |
Denver HMP Setting Facility Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,621.81 | Facility | None | $831.76 | $1,148.15 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,698.24 | Professional | None | $794.33 | $1,148.15 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $794.33 Median $1,584.89 Typical High $1,698.24 | Facility | None | $794.33 | $1,584.89 | $1,698.24 |
Select Health Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,548.82 | Professional | None | $562.34 | $794.33 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $10,232.93 | Facility | None | $1,479.11 | $3,548.13 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,318.26 | $2,089.30 |
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 $416.87 Median $416.87 Typical High $501.19 | Professional | 52 · Reduced service | $416.87 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $199.53 | Professional | 53 · Discontinued | $165.96 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | 54 · Surgery only | $630.96 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $151.36 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $100.00 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $707.95 |
Where Colorado sits
The same service costs 6.3 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· 9th of 51
$1,820
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.