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 $138.04 Median $1,202.26 Typical High $7,585.78 | Facility | None | $138.04 | $1,202.26 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $234.42 | Professional | None | $109.65 | $154.88 | $234.42 |
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 $125.89 Median $190.55 Typical High $346.74 | Professional | None | $125.89 | $190.55 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $144.54 Typical High $263.03 | Facility | None | $52.48 | $144.54 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $229.09 | Professional | None | $100.00 | $147.91 | $229.09 |
Denver HMP Setting Facility Modifier None Typical Low $109.65 Median $154.88 Typical High $234.42 | Facility | None | $109.65 | $154.88 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $275.42 | Professional | None | $109.65 | $177.83 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $186.21 Typical High $346.74 | Facility | None | $162.18 | $186.21 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $74.13 Median $131.83 Typical High $162.18 | Professional | None | $74.13 | $131.83 | $162.18 |
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 $107.15 Median $162.18 Typical High $275.42 | Professional | None | $107.15 | $162.18 | $275.42 |
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 $54.95 Median $66.07 Typical High $77.62 | Professional | 52 · Reduced service | $54.95 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $26.30 Typical High $31.62 | Professional | 53 · Discontinued | $21.88 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $100.00 Typical High $117.49 | Professional | 54 · Surgery only | $81.28 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $19.95 Typical High $23.44 | Professional | 55 · Aftercare only | $16.22 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.18 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.96 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $93.33 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $75.86 | $93.33 | $109.65 |
Where Colorado sits
The same service costs 4.1 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· 14th of 51
$191
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.