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 $1,513.56 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,513.56 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $562.34 | Professional | None | $457.09 | $457.09 | $562.34 |
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 $537.03 Median $758.58 Typical High $1,122.02 | Professional | None | $537.03 | $758.58 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,380.38 Typical High $2,187.76 | Facility | None | $588.84 | $1,380.38 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $812.83 | Professional | None | $467.74 | $575.44 | $812.83 |
Denver HMP Setting Facility Modifier None Typical Low $457.09 Median $575.44 Typical High $1,096.48 | Facility | None | $457.09 | $575.44 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $870.96 | Professional | None | $436.52 | $588.84 | $870.96 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $870.96 Typical High $1,584.89 | Facility | None | $436.52 | $870.96 | $1,584.89 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $660.69 | Professional | None | $436.52 | $478.63 | $660.69 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $933.25 | Professional | None | $467.74 | $602.56 | $933.25 |
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 $229.09 Median $229.09 Typical High $234.42 | Professional | 52 · Reduced service | $229.09 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $93.33 | Professional | 53 · Discontinued | $91.20 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $346.74 | Professional | 54 · Surgery only | $338.84 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $46.77 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $323.59 |
Where Colorado sits
The same service costs 5.8 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· 12th of 51
$759
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.