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 $6,025.60 Typical High $10,715.19 | Facility | None | $2,570.40 | $6,025.60 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,659.59 | $1,659.59 | $1,905.46 |
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 $1,949.84 Median $2,754.23 Typical High $4,073.80 | Professional | None | $1,949.84 | $2,754.23 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $4,365.16 Typical High $6,760.83 | Facility | None | $1,513.56 | $4,365.16 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $3,090.30 | Professional | None | $1,659.59 | $2,137.96 | $3,090.30 |
Denver HMP Setting Facility Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $4,168.69 | Facility | None | $1,659.59 | $2,137.96 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,187.76 | $3,467.37 |
Select Health Setting Facility Modifier None Typical Low $1,659.59 Median $3,311.31 Typical High $3,467.37 | Facility | None | $1,659.59 | $3,311.31 | $3,467.37 |
Select Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,659.59 | $1,778.28 | $2,511.89 |
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 $1,621.81 Median $2,187.76 Typical High $3,548.13 | Professional | None | $1,621.81 | $2,187.76 | $3,548.13 |
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 $831.76 Median $831.76 Typical High $870.96 | Professional | 52 · Reduced service | $831.76 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $346.74 | Professional | 53 · Discontinued | $331.13 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $257.04 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $173.78 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,202.26 |
Where Colorado sits
The same service costs 6.0 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· 14th 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.