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 $97.72 Median $134.90 Typical High $199.53 | Professional | None | $97.72 | $134.90 | $199.53 |
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 $114.82 Median $186.21 Typical High $346.74 | Professional | None | $114.82 | $186.21 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $125.89 Typical High $229.09 | Facility | None | $52.48 | $125.89 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $229.09 | Professional | None | $107.15 | $151.36 | $229.09 |
Denver HMP Setting Facility Modifier None Typical Low $100.00 Median $151.36 Typical High $223.87 | Facility | None | $100.00 | $151.36 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $257.04 | Professional | None | $100.00 | $154.88 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $162.18 Typical High $323.59 | Facility | None | $151.36 | $162.18 | $323.59 |
Select Health Setting Professional Modifier None Typical Low $57.54 Median $102.33 Typical High $151.36 | Professional | None | $57.54 | $102.33 | $151.36 |
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 $104.71 Median $162.18 Typical High $269.15 | Professional | None | $104.71 | $162.18 | $269.15 |
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 $50.12 Median $64.57 Typical High $77.62 | Professional | 52 · Reduced service | $50.12 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $26.30 Typical High $30.90 | Professional | 53 · Discontinued | $19.95 | $26.30 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $97.72 Typical High $117.49 | Professional | 54 · Surgery only | $74.13 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $19.50 Typical High $23.44 | Professional | 55 · Aftercare only | $14.79 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.88 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.00 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $91.20 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $69.18 | $91.20 | $109.65 |
Where Colorado sits
The same service costs 3.5 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· 10th of 51
$186
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.