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 $2,691.53 Median $5,495.41 Typical High $12,882.50 | Facility | None | $2,691.53 | $5,495.41 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $6,025.60 | Professional | None | $1,318.26 | $1,348.96 | $6,025.60 |
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 $1,513.56 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,513.56 | $2,187.76 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $4,168.69 Typical High $5,754.40 | Facility | None | $1,318.26 | $4,168.69 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,348.96 | $1,862.09 | $2,454.71 |
Denver HMP Setting Facility Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $2,344.23 | Facility | None | $1,348.96 | $1,698.24 | $2,344.23 |
Kaiser Permanente 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 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $2,398.83 Typical High $5,011.87 | Facility | None | $1,202.26 | $2,398.83 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $2,344.23 | Professional | None | $851.14 | $1,202.26 | $2,344.23 |
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 $1,412.54 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,412.54 | $1,778.28 | $2,818.38 |
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 $630.96 Median $676.08 Typical High $707.95 | Professional | 52 · Reduced service | $630.96 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $269.15 Typical High $281.84 | Professional | 53 · Discontinued | $251.19 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,000.00 Typical High $1,071.52 | Professional | 54 · Surgery only | $933.25 | $1,000.00 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $199.53 Typical High $213.80 | Professional | 55 · Aftercare only | $190.55 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $134.90 Typical High $141.25 | Professional | 56 · Pre-op care only | $125.89 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $933.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $870.96 | $933.25 | $1,000.00 |
Where Colorado sits
The same service costs 6.2 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· 10th 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.