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 $131.83 Median $1,148.15 Typical High $7,585.78 | Facility | None | $131.83 | $1,148.15 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $208.93 | Professional | None | $104.71 | $131.83 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $288.40 | Professional | None | $123.03 | $169.82 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $107.15 Typical High $194.98 | Facility | None | $52.48 | $107.15 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $190.55 | Professional | None | $97.72 | $131.83 | $190.55 |
Denver HMP Setting Facility Modifier None Typical Low $109.65 Median $141.25 Typical High $190.55 | Facility | None | $109.65 | $141.25 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $234.42 | Professional | None | $107.15 | $158.49 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $131.83 Median $141.25 Typical High $281.84 | Facility | None | $131.83 | $141.25 | $281.84 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $128.82 Typical High $144.54 | Professional | None | $72.44 | $128.82 | $144.54 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $229.09 | Professional | None | $104.71 | $138.04 | $229.09 |
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 $52.48 Median $54.95 Typical High $66.07 | Professional | 52 · Reduced service | $52.48 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $22.39 Typical High $26.30 | Professional | 53 · Discontinued | $21.38 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $83.18 Typical High $100.00 | Professional | 54 · Surgery only | $79.43 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.60 Typical High $19.95 | Professional | 55 · Aftercare only | $15.85 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.96 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.47 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $77.62 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $74.13 | $77.62 | $93.33 |
Where Colorado sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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· 16th of 51
$162
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.