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 $199.53 Median $3,235.94 Typical High $7,762.47 | Facility | None | $199.53 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $281.84 | Professional | None | $151.36 | $199.53 | $281.84 |
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 $173.78 Median $251.19 Typical High $446.68 | Professional | None | $173.78 | $251.19 | $446.68 |
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 $151.36 Median $199.53 Typical High $295.12 | Professional | None | $151.36 | $199.53 | $295.12 |
Denver HMP Setting Facility Modifier None Typical Low $151.36 Median $208.93 Typical High $288.40 | Facility | None | $151.36 | $208.93 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $346.74 | Professional | None | $141.25 | $229.09 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $213.80 Typical High $426.58 | Facility | None | $199.53 | $213.80 | $426.58 |
Select Health Setting Professional Modifier None Typical Low $95.50 Median $165.96 Typical High $199.53 | Professional | None | $95.50 | $165.96 | $199.53 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,122.02 Typical High $2,884.03 | Facility | None | $489.78 | $1,122.02 | $2,884.03 |
United Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $346.74 | Professional | None | $158.49 | $213.80 | $346.74 |
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 $75.86 Median $83.18 Typical High $100.00 | Professional | 52 · Reduced service | $75.86 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $33.11 Typical High $39.81 | Professional | 53 · Discontinued | $30.20 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $125.89 Typical High $147.91 | Professional | 54 · Surgery only | $114.82 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $25.12 Typical High $30.20 | Professional | 55 · Aftercare only | $22.91 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.60 Typical High $19.95 | Professional | 56 · Pre-op care only | $15.14 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $117.49 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $107.15 | $117.49 | $138.04 |
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· 15th of 51
$251
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.