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 $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,318.26 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $15,135.61 Typical High $25,703.96 | Facility | None | $9,772.37 | $15,135.61 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,548.82 | $2,187.76 | $3,235.94 |
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 $1,380.38 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,380.38 | $1,905.46 | $2,630.27 |
Denver HMP Setting Facility Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $3,311.31 | Facility | None | $1,318.26 | $1,698.24 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,318.26 | $1,862.09 | $2,818.38 |
Select Health Setting Facility Modifier None Typical Low $1,318.26 Median $2,691.53 Typical High $2,818.38 | Facility | None | $1,318.26 | $2,691.53 | $2,818.38 |
Select Health Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $2,570.40 | Professional | None | $933.25 | $1,318.26 | $2,570.40 |
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 $1,445.44 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,445.44 | $1,949.84 | $3,090.30 |
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 $660.69 Median $660.69 Typical High $794.33 | Professional | 52 · Reduced service | $660.69 | $660.69 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $316.23 | Professional | 53 · Discontinued | $263.03 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $158.49 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,096.48 |
Where Colorado sits
The same service costs 5.8 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· 11th 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.