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 $134.90 Median $3,235.94 Typical High $7,762.47 | Facility | None | $134.90 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $208.93 | Professional | None | $117.49 | $134.90 | $208.93 |
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 $138.04 Median $194.98 Typical High $288.40 | Professional | None | $138.04 | $194.98 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $190.55 Typical High $1,659.59 | Facility | None | $109.65 | $190.55 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $245.47 | Professional | None | $141.25 | $173.78 | $245.47 |
Denver HMP Setting Facility Modifier None Typical Low $117.49 Median $194.98 Typical High $275.42 | Facility | None | $117.49 | $194.98 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $245.47 | Professional | None | $131.83 | $181.97 | $245.47 |
Select Health Setting Facility Modifier None Typical Low $134.90 Median $144.54 Typical High $309.03 | Facility | None | $134.90 | $144.54 | $309.03 |
Select Health Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $165.96 | Professional | None | $117.49 | $144.54 | $165.96 |
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 $131.83 Median $173.78 Typical High $269.15 | Professional | None | $131.83 | $173.78 | $269.15 |
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 $58.88 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $58.88 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $23.44 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $102.33 Typical High $102.33 | Professional | 54 · Surgery only | $87.10 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $17.78 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $11.75 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $95.50 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $81.28 | $95.50 | $95.50 |
Where Colorado sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 19th of 51
$186
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.