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 $165.96 Median $3,162.28 Typical High $7,762.47 | Facility | None | $165.96 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $165.96 Typical High $309.03 | Professional | None | $102.33 | $165.96 | $309.03 |
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 $234.42 Typical High $407.38 | Professional | None | $144.54 | $234.42 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $245.47 Typical High $1,659.59 | Facility | None | $141.25 | $245.47 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $302.00 | Professional | None | $112.20 | $173.78 | $302.00 |
Denver HMP Setting Facility Modifier None Typical Low $102.33 Median $158.49 Typical High $257.04 | Facility | None | $102.33 | $158.49 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $331.13 | Professional | None | $112.20 | $194.98 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $190.55 Typical High $398.11 | Facility | None | $173.78 | $190.55 | $398.11 |
Select Health Setting Professional Modifier None Typical Low $70.79 Median $190.55 Typical High $371.54 | Professional | None | $70.79 | $190.55 | $371.54 |
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 $114.82 Median $173.78 Typical High $338.84 | Professional | None | $114.82 | $173.78 | $338.84 |
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 $51.29 Median $75.86 Typical High $87.10 | Professional | 52 · Reduced service | $51.29 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $30.20 Typical High $34.67 | Professional | 53 · Discontinued | $20.42 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $112.20 Typical High $128.82 | Professional | 54 · Surgery only | $77.62 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $22.91 Typical High $26.30 | Professional | 55 · Aftercare only | $15.49 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $15.14 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.23 | $15.14 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $104.71 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $72.44 | $104.71 | $120.23 |
Where Colorado sits
The same service costs 3.6 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
$234
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.