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 $169.82 Median $263.03 Typical High $467.74 | Professional | None | $169.82 | $263.03 | $467.74 |
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 $213.80 Median $346.74 Typical High $602.56 | Professional | None | $213.80 | $346.74 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $389.05 Typical High $1,659.59 | Facility | None | $263.03 | $389.05 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $446.68 | Professional | None | $190.55 | $295.12 | $446.68 |
Denver HMP Setting Facility Modifier None Typical Low $169.82 Median $263.03 Typical High $436.52 | Facility | None | $169.82 | $263.03 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $281.84 Typical High $467.74 | Professional | None | $173.78 | $281.84 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $263.03 Median $316.23 Typical High $549.54 | Facility | None | $263.03 | $316.23 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $263.03 Typical High $512.86 | Professional | None | $112.20 | $263.03 | $512.86 |
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 $194.98 Median $309.03 Typical High $512.86 | Professional | None | $194.98 | $309.03 | $512.86 |
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 $85.11 Median $128.82 Typical High $134.90 | Professional | 52 · Reduced service | $85.11 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $51.29 Typical High $54.95 | Professional | 53 · Discontinued | $33.88 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $190.55 Typical High $204.17 | Professional | 54 · Surgery only | $128.82 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $38.90 Typical High $40.74 | Professional | 55 · Aftercare only | $25.70 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $25.70 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.98 | $25.70 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $177.83 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $120.23 | $177.83 | $190.55 |
Where Colorado sits
The same service costs 4.3 times more in Wisconsin 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
$372
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.