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 $169.82 Median $3,235.94 Typical High $8,912.51 | Facility | None | $169.82 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $245.47 | Professional | None | $114.82 | $147.91 | $245.47 |
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 $134.90 Median $204.17 Typical High $331.13 | Professional | None | $134.90 | $204.17 | $331.13 |
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 $120.23 Median $169.82 Typical High $251.19 | Professional | None | $120.23 | $169.82 | $251.19 |
Denver HMP Setting Facility Modifier None Typical Low $125.89 Median $169.82 Typical High $245.47 | Facility | None | $125.89 | $169.82 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $169.82 Typical High $257.04 | Professional | None | $109.65 | $169.82 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $199.53 Typical High $316.23 | Facility | None | $151.36 | $199.53 | $316.23 |
Select Health Setting Professional Modifier None Typical Low $69.18 Median $151.36 Typical High $295.12 | Professional | None | $69.18 | $151.36 | $295.12 |
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 $120.23 Median $169.82 Typical High $288.40 | Professional | None | $120.23 | $169.82 | $288.40 |
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 $63.10 Median $70.79 Typical High $85.11 | Professional | 52 · Reduced service | $63.10 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $28.18 Typical High $33.88 | Professional | 53 · Discontinued | $25.12 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $104.71 Typical High $128.82 | Professional | 54 · Surgery only | $93.33 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $20.89 Typical High $25.70 | Professional | 55 · Aftercare only | $19.05 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.13 Typical High $16.98 | Professional | 56 · Pre-op care only | $12.59 | $14.13 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $97.72 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $87.10 | $97.72 | $120.23 |
Where Colorado sits
The same service costs 4.2 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· 9th of 51
$214
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.