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 $1,023.29 Median $1,023.29 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,023.29 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,698.24 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,137.96 Typical High $2,818.38 | Facility | None | $758.58 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $1,995.26 | Professional | None | $977.24 | $1,479.11 | $1,995.26 |
Denver HMP Setting Facility Modifier None Typical Low $912.01 Median $1,230.27 Typical High $2,570.40 | Facility | None | $912.01 | $1,230.27 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,445.44 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $1,023.29 Median $2,041.74 Typical High $2,454.71 | Facility | None | $1,023.29 | $2,041.74 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,995.26 | Professional | None | $724.44 | $1,023.29 | $1,995.26 |
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 $977.24 Median $1,445.44 Typical High $2,344.23 | Professional | None | $977.24 | $1,445.44 | $2,344.23 |
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 $501.19 Median $501.19 Typical High $602.56 | Professional | 52 · Reduced service | $501.19 | $501.19 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $239.88 | Professional | 53 · Discontinued | $204.17 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $912.01 | Professional | 54 · Surgery only | $758.58 | $758.58 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $181.97 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $120.23 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $851.14 |
Where Colorado sits
The same service costs 6.6 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
$1,995
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.