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 $120.23 Median $3,235.94 Typical High $8,709.64 | Facility | None | $120.23 | $3,235.94 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $144.54 | Professional | None | $79.43 | $109.65 | $144.54 |
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 $91.20 Median $128.82 Typical High $194.98 | Professional | None | $91.20 | $128.82 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $199.53 Typical High $1,659.59 | Facility | None | $114.82 | $199.53 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $186.21 | Professional | None | $89.13 | $120.23 | $186.21 |
Denver HMP Setting Facility Modifier None Typical Low $79.43 Median $120.23 Typical High $186.21 | Facility | None | $79.43 | $120.23 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $218.78 | Professional | None | $89.13 | $141.25 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $128.82 Median $147.91 Typical High $269.15 | Facility | None | $128.82 | $147.91 | $269.15 |
Select Health Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $128.82 | Professional | None | $79.43 | $97.72 | $128.82 |
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 $85.11 Median $123.03 Typical High $208.93 | Professional | None | $85.11 | $123.03 | $208.93 |
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 $39.81 Median $50.12 Typical High $60.26 | Professional | 52 · Reduced service | $39.81 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $20.42 Typical High $23.99 | Professional | 53 · Discontinued | $15.85 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $75.86 Typical High $89.13 | Professional | 54 · Surgery only | $60.26 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.14 Typical High $17.78 | Professional | 55 · Aftercare only | $12.02 | $15.14 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.00 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.94 | $10.00 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $70.79 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $56.23 | $70.79 | $83.18 |
Where Colorado sits
The same service costs 3.7 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· 19th of 51
$132
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.