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 $218.78 Median $2,570.40 Typical High $7,585.78 | Facility | None | $218.78 | $2,570.40 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $354.81 | Professional | None | $173.78 | $218.78 | $354.81 |
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 $213.80 Median $288.40 Typical High $478.63 | Professional | None | $213.80 | $288.40 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $288.40 Typical High $1,659.59 | Facility | None | $165.96 | $288.40 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $323.59 | Professional | None | $173.78 | $229.09 | $323.59 |
Denver HMP Setting Facility Modifier None Typical Low $190.55 Median $234.42 Typical High $316.23 | Facility | None | $190.55 | $234.42 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $398.11 | Professional | None | $181.97 | $275.42 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $229.09 Typical High $478.63 | Facility | None | $199.53 | $229.09 | $478.63 |
Select Health Setting Professional Modifier None Typical Low $123.03 Median $218.78 Typical High $245.47 | Professional | None | $123.03 | $218.78 | $245.47 |
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 $186.21 Median $239.88 Typical High $407.38 | Professional | None | $186.21 | $239.88 | $407.38 |
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 $91.20 Median $95.50 Typical High $109.65 | Professional | 52 · Reduced service | $91.20 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.02 Typical High $43.65 | Professional | 53 · Discontinued | $36.31 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $141.25 Typical High $165.96 | Professional | 54 · Surgery only | $138.04 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.84 Typical High $33.11 | Professional | 55 · Aftercare only | $27.54 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.05 Typical High $21.88 | Professional | 56 · Pre-op care only | $18.20 | $19.05 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $131.83 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $128.82 | $131.83 | $154.88 |
Where Colorado sits
The same service costs 4.4 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· 16th of 51
$282
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.