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 $229.09 Median $3,235.94 Typical High $7,762.47 | Facility | None | $229.09 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $338.84 | Professional | None | $169.82 | $229.09 | $338.84 |
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 $194.98 Median $281.84 Typical High $512.86 | Professional | None | $194.98 | $281.84 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,071.52 Typical High $1,659.59 | Facility | None | $436.52 | $1,071.52 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $338.84 | Professional | None | $165.96 | $218.78 | $338.84 |
Denver HMP Setting Facility Modifier None Typical Low $169.82 Median $229.09 Typical High $338.84 | Facility | None | $169.82 | $229.09 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $398.11 | Professional | None | $162.18 | $263.03 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $446.68 Typical High $1,230.27 | Facility | None | $239.88 | $446.68 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $239.88 | Professional | None | $107.15 | $190.55 | $239.88 |
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 $173.78 Median $245.47 Typical High $398.11 | Professional | None | $173.78 | $245.47 | $398.11 |
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 $85.11 Median $97.72 Typical High $114.82 | Professional | 52 · Reduced service | $85.11 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $38.90 Typical High $46.77 | Professional | 53 · Discontinued | $33.88 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $147.91 Typical High $173.78 | Professional | 54 · Surgery only | $128.82 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $29.51 Typical High $34.67 | Professional | 55 · Aftercare only | $25.70 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.50 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.98 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $138.04 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $120.23 | $138.04 | $162.18 |
Where Colorado sits
The same service costs 4.6 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· 17th of 51
$288
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.