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 $1,258.93 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $346.74 | Professional | None | $151.36 | $234.42 | $346.74 |
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 $223.87 Median $363.08 Typical High $660.69 | Professional | None | $223.87 | $363.08 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $239.88 Typical High $436.52 | Facility | None | $52.48 | $239.88 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $436.52 | Professional | None | $204.17 | $281.84 | $436.52 |
Denver HMP Setting Facility Modifier None Typical Low $151.36 Median $275.42 Typical High $446.68 | Facility | None | $151.36 | $275.42 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $512.86 | Professional | None | $199.53 | $316.23 | $512.86 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $309.03 Typical High $645.65 | Facility | None | $288.40 | $309.03 | $645.65 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $218.78 Typical High $302.00 | Professional | None | $125.89 | $218.78 | $302.00 |
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 $208.93 Median $316.23 Typical High $524.81 | Professional | None | $208.93 | $316.23 | $524.81 |
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 $75.86 Median $117.49 Typical High $147.91 | Professional | 52 · Reduced service | $75.86 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $46.77 Typical High $58.88 | Professional | 53 · Discontinued | $30.20 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $173.78 Typical High $218.78 | Professional | 54 · Surgery only | $114.82 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $35.48 Typical High $43.65 | Professional | 55 · Aftercare only | $22.91 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $23.44 Typical High $29.51 | Professional | 56 · Pre-op care only | $15.14 | $23.44 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $162.18 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $107.15 | $162.18 | $204.17 |
Where Colorado sits
The same service costs 3.5 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
$363
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.