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 $177.83 Median $3,235.94 Typical High $8,709.64 | Facility | None | $177.83 | $3,235.94 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $316.23 | Professional | None | $125.89 | $177.83 | $316.23 |
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 $169.82 Median $269.15 Typical High $446.68 | Professional | None | $169.82 | $269.15 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $275.42 Typical High $2,691.53 | Facility | None | $158.49 | $275.42 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $199.53 Typical High $316.23 | Professional | None | $134.90 | $199.53 | $316.23 |
Denver HMP Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $263.03 | Facility | None | $125.89 | $177.83 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $338.84 | Professional | None | $134.90 | $208.93 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $190.55 Median $208.93 Typical High $407.38 | Facility | None | $190.55 | $208.93 | $407.38 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $190.55 Typical High $371.54 | Professional | None | $85.11 | $190.55 | $371.54 |
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 $138.04 Median $194.98 Typical High $354.81 | Professional | None | $138.04 | $194.98 | $354.81 |
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 $79.43 Typical High $89.13 | Professional | 52 · Reduced service | $63.10 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $32.36 Typical High $36.31 | Professional | 53 · Discontinued | $25.12 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $120.23 Typical High $134.90 | Professional | 54 · Surgery only | $93.33 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $23.99 Typical High $26.92 | Professional | 55 · Aftercare only | $18.62 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.22 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.59 | $16.22 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $112.20 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $87.10 | $112.20 | $125.89 |
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· 9th of 51
$269
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.