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 $53.70 Median $3,235.94 Typical High $8,912.51 | Facility | None | $53.70 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $50.12 Typical High $67.61 | Professional | None | $46.77 | $50.12 | $67.61 |
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 $54.95 Median $72.44 Typical High $120.23 | Professional | None | $54.95 | $72.44 | $120.23 |
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 $50.12 Median $60.26 Typical High $79.43 | Professional | None | $50.12 | $60.26 | $79.43 |
Denver HMP Setting Facility Modifier None Typical Low $50.12 Median $63.10 Typical High $77.62 | Facility | None | $50.12 | $63.10 | $77.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $66.07 Typical High $91.20 | Professional | None | $43.65 | $66.07 | $91.20 |
Select Health Setting Facility Modifier None Typical Low $53.70 Median $85.11 Typical High $114.82 | Facility | None | $53.70 | $85.11 | $114.82 |
Select Health Setting Professional Modifier None Typical Low $30.20 Median $52.48 Typical High $60.26 | Professional | None | $30.20 | $52.48 | $60.26 |
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 $51.29 Median $63.10 Typical High $102.33 | Professional | None | $51.29 | $63.10 | $102.33 |
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 $22.91 Median $25.12 Typical High $26.92 | Professional | 52 · Reduced service | $22.91 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $10.00 Typical High $10.72 | Professional | 53 · Discontinued | $9.12 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $38.02 Typical High $40.74 | Professional | 54 · Surgery only | $34.67 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.59 Typical High $8.13 | Professional | 55 · Aftercare only | $6.92 | $7.59 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.01 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.57 | $5.01 | $5.37 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $32.36 Median $35.48 Typical High $38.02 | Professional | 78 · Unplanned return to OR | $32.36 | $35.48 | $38.02 |
Where Colorado sits
The same service costs 4.6 times more in Alaska than in New York. 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· 14th of 51
$72.44
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.