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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,288.25 | $1,584.89 |
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 $1,479.11 Median $2,137.96 Typical High $3,162.28 | Professional | None | $1,479.11 | $2,137.96 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,466.84 Typical High $7,943.28 | Facility | None | $691.83 | $4,466.84 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,621.81 | $2,344.23 |
Denver HMP Setting Facility Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,951.21 | Facility | None | $1,288.25 | $1,659.59 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,584.89 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,202.26 | $2,398.83 | $6,918.31 |
Select Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,778.28 | Professional | None | $1,202.26 | $1,380.38 | $1,778.28 |
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 $1,348.96 Median $1,737.80 Typical High $2,691.53 | Professional | None | $1,348.96 | $1,737.80 | $2,691.53 |
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 $645.65 Median $645.65 Typical High $660.69 | Professional | 52 · Reduced service | $645.65 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $269.15 | Professional | 53 · Discontinued | $257.04 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,000.00 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $199.53 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $933.25 |
Where Colorado sits
The same service costs 11.0 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· 13th of 51
$2,138
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.