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 $186.21 Median $3,090.30 Typical High $8,912.51 | Facility | None | $186.21 | $3,090.30 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $363.08 | Professional | None | $138.04 | $229.09 | $363.08 |
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 $151.36 Median $208.93 Typical High $309.03 | Professional | None | $151.36 | $208.93 | $309.03 |
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 $134.90 Median $229.09 Typical High $354.81 | Professional | None | $134.90 | $229.09 | $354.81 |
Denver HMP Setting Facility Modifier None Typical Low $147.91 Median $251.19 Typical High $354.81 | Facility | None | $147.91 | $251.19 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $380.19 | Professional | None | $131.83 | $223.87 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $239.88 Typical High $467.74 | Facility | None | $223.87 | $239.88 | $467.74 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $223.87 Typical High $436.52 | Professional | None | $83.18 | $223.87 | $436.52 |
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 $134.90 Median $234.42 Typical High $407.38 | Professional | None | $134.90 | $234.42 | $407.38 |
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 $72.44 Median $95.50 Typical High $125.89 | Professional | 52 · Reduced service | $72.44 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $38.90 Typical High $50.12 | Professional | 53 · Discontinued | $29.51 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $144.54 Typical High $186.21 | Professional | 54 · Surgery only | $109.65 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $28.84 Typical High $37.15 | Professional | 55 · Aftercare only | $21.88 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $19.05 Typical High $25.12 | Professional | 56 · Pre-op care only | $14.79 | $19.05 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $134.90 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $102.33 | $134.90 | $173.78 |
Where Colorado sits
The same service costs 4.5 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· 14th of 51
$251
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.