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 $112.20 Median $3,235.94 Typical High $7,762.47 | Facility | None | $112.20 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $177.83 | Professional | None | $72.44 | $112.20 | $177.83 |
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 $79.43 Median $138.04 Typical High $245.47 | Professional | None | $79.43 | $138.04 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,698.24 | Facility | None | $50.12 | $66.07 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $109.65 Typical High $162.18 | Professional | None | $72.44 | $109.65 | $162.18 |
Denver HMP Setting Facility Modifier None Typical Low $72.44 Median $109.65 Typical High $169.82 | Facility | None | $72.44 | $109.65 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $199.53 | Professional | None | $75.86 | $117.49 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $128.82 Typical High $245.47 | Facility | None | $117.49 | $128.82 | $245.47 |
Select Health Setting Professional Modifier None Typical Low $45.71 Median $79.43 Typical High $117.49 | Professional | None | $45.71 | $79.43 | $117.49 |
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 $72.44 Median $120.23 Typical High $204.17 | Professional | None | $72.44 | $120.23 | $204.17 |
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 $36.31 Median $46.77 Typical High $58.88 | Professional | 52 · Reduced service | $36.31 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $18.62 Typical High $23.44 | Professional | 53 · Discontinued | $14.45 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $70.79 Typical High $89.13 | Professional | 54 · Surgery only | $53.70 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $14.13 Typical High $17.78 | Professional | 55 · Aftercare only | $10.72 | $14.13 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.33 Typical High $11.75 | Professional | 56 · Pre-op care only | $7.24 | $9.33 | $11.75 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $50.12 Median $66.07 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $50.12 | $66.07 | $83.18 |
Where Colorado sits
The same service costs 3.9 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· 13th of 51
$135
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.