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 $234.42 Median $3,235.94 Typical High $7,762.47 | Facility | None | $234.42 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $331.13 | Professional | None | $181.97 | $234.42 | $331.13 |
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 $208.93 Median $302.00 Typical High $524.81 | Professional | None | $208.93 | $302.00 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $316.23 Typical High $1,659.59 | Facility | None | $181.97 | $316.23 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $346.74 | Professional | None | $186.21 | $239.88 | $346.74 |
Denver HMP Setting Facility Modifier None Typical Low $186.21 Median $257.04 Typical High $338.84 | Facility | None | $186.21 | $257.04 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $407.38 | Professional | None | $169.82 | $275.42 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $239.88 Typical High $501.19 | Facility | None | $223.87 | $239.88 | $501.19 |
Select Health Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $239.88 | Professional | None | $114.82 | $199.53 | $239.88 |
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 $194.98 Median $257.04 Typical High $416.87 | Professional | None | $194.98 | $257.04 | $416.87 |
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 $100.00 Typical High $117.49 | Professional | 52 · Reduced service | $91.20 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $39.81 Typical High $46.77 | Professional | 53 · Discontinued | $36.31 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $151.36 Typical High $177.83 | Professional | 54 · Surgery only | $134.90 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.20 Typical High $35.48 | Professional | 55 · Aftercare only | $26.92 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.95 Typical High $23.44 | Professional | 56 · Pre-op care only | $18.20 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $141.25 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $125.89 | $141.25 | $165.96 |
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· 16th of 51
$295
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.