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 $295.12 Median $3,235.94 Typical High $8,709.64 | Facility | None | $295.12 | $3,235.94 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $363.08 | Professional | None | $229.09 | $281.84 | $363.08 |
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 $269.15 Median $371.54 Typical High $645.65 | Professional | None | $269.15 | $371.54 | $645.65 |
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 $239.88 Median $302.00 Typical High $426.58 | Professional | None | $239.88 | $302.00 | $426.58 |
Denver HMP Setting Facility Modifier None Typical Low $234.42 Median $331.13 Typical High $416.87 | Facility | None | $234.42 | $331.13 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $346.74 Typical High $501.19 | Professional | None | $213.80 | $346.74 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $549.54 Typical High $1,230.27 | Facility | None | $295.12 | $549.54 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $141.25 Median $251.19 Typical High $295.12 | Professional | None | $141.25 | $251.19 | $295.12 |
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 $245.47 Median $323.59 Typical High $524.81 | Professional | None | $245.47 | $323.59 | $524.81 |
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 $114.82 Median $125.89 Typical High $144.54 | Professional | 52 · Reduced service | $114.82 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $51.29 Typical High $58.88 | Professional | 53 · Discontinued | $45.71 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $190.55 Typical High $218.78 | Professional | 54 · Surgery only | $169.82 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.02 Typical High $43.65 | Professional | 55 · Aftercare only | $33.88 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.70 Typical High $29.51 | Professional | 56 · Pre-op care only | $22.91 | $25.70 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $177.83 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $158.49 | $177.83 | $204.17 |
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· 13th of 51
$380
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.