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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $309.03 | Professional | None | $154.88 | $213.80 | $309.03 |
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 $181.97 Median $288.40 Typical High $524.81 | Professional | None | $181.97 | $288.40 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $331.13 Typical High $1,659.59 | Facility | None | $194.98 | $331.13 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $346.74 | Professional | None | $158.49 | $234.42 | $346.74 |
Denver HMP Setting Facility Modifier None Typical Low $154.88 Median $229.09 Typical High $338.84 | Facility | None | $154.88 | $229.09 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $407.38 | Professional | None | $154.88 | $239.88 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $257.04 Typical High $501.19 | Facility | None | $239.88 | $257.04 | $501.19 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $239.88 | Professional | None | $91.20 | $162.18 | $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 $162.18 Median $251.19 Typical High $416.87 | Professional | None | $162.18 | $251.19 | $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 $75.86 Median $100.00 Typical High $117.49 | Professional | 52 · Reduced service | $75.86 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $39.81 Typical High $46.77 | Professional | 53 · Discontinued | $30.90 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $147.91 Typical High $177.83 | Professional | 54 · Surgery only | $114.82 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $29.51 Typical High $35.48 | Professional | 55 · Aftercare only | $22.91 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.95 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.49 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $138.04 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $107.15 | $138.04 | $165.96 |
Where Colorado sits
The same service costs 3.4 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· 12th 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.