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 $245.47 Median $3,235.94 Typical High $8,912.51 | Facility | None | $245.47 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $338.84 | Professional | None | $186.21 | $245.47 | $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 $213.80 Median $302.00 Typical High $537.03 | Professional | None | $213.80 | $302.00 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,122.02 Typical High $2,187.76 | Facility | None | $588.84 | $1,122.02 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $354.81 | Professional | None | $186.21 | $245.47 | $354.81 |
Denver HMP Setting Facility Modifier None Typical Low $186.21 Median $269.15 Typical High $354.81 | Facility | None | $186.21 | $269.15 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $426.58 | Professional | None | $177.83 | $288.40 | $426.58 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $467.74 Typical High $1,230.27 | Facility | None | $251.19 | $467.74 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $251.19 | Professional | None | $117.49 | $208.93 | $251.19 |
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 $194.98 Median $269.15 Typical High $426.58 | Professional | None | $194.98 | $269.15 | $426.58 |
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 $93.33 Median $104.71 Typical High $123.03 | Professional | 52 · Reduced service | $93.33 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $41.69 Typical High $48.98 | Professional | 53 · Discontinued | $37.15 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $154.88 Typical High $186.21 | Professional | 54 · Surgery only | $141.25 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $28.18 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $20.89 Typical High $24.55 | Professional | 56 · Pre-op care only | $18.62 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $144.54 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $131.83 | $144.54 | $173.78 |
Where Colorado sits
The same service costs 4.7 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· 16th of 51
$309
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.