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 $125.89 Median $3,235.94 Typical High $8,709.64 | Facility | None | $125.89 | $3,235.94 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $125.89 | Professional | None | $91.20 | $123.03 | $125.89 |
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 $109.65 Median $173.78 Typical High $288.40 | Professional | None | $109.65 | $173.78 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $104.71 Typical High $190.55 | Facility | None | $52.48 | $104.71 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $208.93 | Professional | None | $97.72 | $131.83 | $208.93 |
Denver HMP Setting Facility Modifier None Typical Low $91.20 Median $131.83 Typical High $213.80 | Facility | None | $91.20 | $131.83 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $223.87 | Professional | None | $102.33 | $154.88 | $223.87 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $134.90 Typical High $281.84 | Facility | None | $125.89 | $134.90 | $281.84 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $131.83 | Professional | None | $91.20 | $109.65 | $131.83 |
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 $95.50 Median $131.83 Typical High $223.87 | Professional | None | $95.50 | $131.83 | $223.87 |
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 $45.71 Median $56.23 Typical High $63.10 | Professional | 52 · Reduced service | $45.71 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $22.39 Typical High $25.70 | Professional | 53 · Discontinued | $18.20 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $83.18 Typical High $95.50 | Professional | 54 · Surgery only | $69.18 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.98 Typical High $19.05 | Professional | 55 · Aftercare only | $13.80 | $16.98 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.22 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.12 | $11.22 | $12.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $77.62 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $64.57 | $77.62 | $89.13 |
Where Colorado sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 16th of 51
$158
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.