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 $144.54 Median $269.15 Typical High $537.03 | Professional | None | $144.54 | $269.15 | $537.03 |
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 $144.54 Median $204.17 Typical High $302.00 | Professional | None | $144.54 | $204.17 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $269.15 Typical High $489.78 | Facility | None | $52.48 | $269.15 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $457.09 | Professional | None | $141.25 | $234.42 | $457.09 |
Denver HMP Setting Facility Modifier None Typical Low $147.91 Median $288.40 Typical High $457.09 | Facility | None | $147.91 | $288.40 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $251.19 Typical High $478.63 | Professional | None | $125.89 | $251.19 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $229.09 Median $331.13 Typical High $588.84 | Facility | None | $229.09 | $331.13 | $588.84 |
Select Health Setting Professional Modifier None Typical Low $79.43 Median $223.87 Typical High $549.54 | Professional | None | $79.43 | $223.87 | $549.54 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,995.26 | Facility | None | $239.88 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $501.19 | Professional | None | $141.25 | $245.47 | $501.19 |
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 $74.13 Median $123.03 Typical High $158.49 | Professional | 52 · Reduced service | $74.13 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $48.98 Typical High $64.57 | Professional | 53 · Discontinued | $29.51 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $181.97 Typical High $239.88 | Professional | 54 · Surgery only | $109.65 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $36.31 Typical High $47.86 | Professional | 55 · Aftercare only | $21.88 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $24.55 Typical High $31.62 | Professional | 56 · Pre-op care only | $14.79 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $169.82 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $102.33 | $169.82 | $223.87 |
Where Colorado sits
The same service costs 3.9 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· 16th of 51
$275
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.