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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $134.90 | Professional | None | $72.44 | $95.50 | $134.90 |
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 $85.11 Median $125.89 Typical High $229.09 | Professional | None | $85.11 | $125.89 | $229.09 |
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 $100.00 Typical High $151.36 | Professional | None | $72.44 | $100.00 | $151.36 |
Denver HMP Setting Facility Modifier None Typical Low $72.44 Median $102.33 Typical High $147.91 | Facility | None | $72.44 | $102.33 | $147.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $107.15 Typical High $169.82 | Professional | None | $66.07 | $107.15 | $169.82 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $120.23 Typical High $213.80 | Facility | None | $100.00 | $120.23 | $213.80 |
Select Health Setting Professional Modifier None Typical Low $42.66 Median $75.86 Typical High $100.00 | Professional | None | $42.66 | $75.86 | $100.00 |
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 $75.86 Median $107.15 Typical High $173.78 | Professional | None | $75.86 | $107.15 | $173.78 |
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 $43.65 Typical High $51.29 | Professional | 52 · Reduced service | $36.31 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $17.38 Typical High $20.42 | Professional | 53 · Discontinued | $14.45 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $64.57 Typical High $77.62 | Professional | 54 · Surgery only | $54.95 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.88 Typical High $15.49 | Professional | 55 · Aftercare only | $10.96 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.71 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.24 | $8.71 | $10.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $60.26 Typical High $72.44 | Professional | 78 · Unplanned return to OR | $51.29 | $60.26 | $72.44 |
Where Colorado sits
The same service costs 3.8 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· 12th of 51
$126
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.