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 $213.80 Median $3,235.94 Typical High $7,762.47 | Facility | None | $213.80 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $302.00 | Professional | None | $162.18 | $213.80 | $302.00 |
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 $186.21 Median $263.03 Typical High $467.74 | Professional | None | $186.21 | $263.03 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $295.12 Typical High $1,659.59 | Facility | None | $169.82 | $295.12 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $309.03 | Professional | None | $162.18 | $213.80 | $309.03 |
Denver HMP Setting Facility Modifier None Typical Low $162.18 Median $223.87 Typical High $309.03 | Facility | None | $162.18 | $223.87 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $371.54 | Professional | None | $154.88 | $251.19 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $204.17 Median $218.78 Typical High $457.09 | Facility | None | $204.17 | $218.78 | $457.09 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $181.97 Typical High $213.80 | Professional | None | $102.33 | $181.97 | $213.80 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $371.54 | Professional | None | $169.82 | $229.09 | $371.54 |
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 $81.28 Median $89.13 Typical High $107.15 | Professional | 52 · Reduced service | $81.28 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $35.48 Typical High $42.66 | Professional | 53 · Discontinued | $32.36 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $134.90 Typical High $158.49 | Professional | 54 · Surgery only | $123.03 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $26.92 Typical High $31.62 | Professional | 55 · Aftercare only | $24.55 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $17.78 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.22 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $125.89 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $114.82 | $125.89 | $147.91 |
Where Colorado sits
The same service costs 4.0 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
$263
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.