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 $407.38 Median $3,311.31 Typical High $8,709.64 | Facility | None | $407.38 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $398.11 | Professional | None | $213.80 | $288.40 | $398.11 |
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 $245.47 Median $371.54 Typical High $676.08 | Professional | None | $245.47 | $371.54 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $234.42 Typical High $524.81 | Facility | None | $52.48 | $234.42 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $446.68 | Professional | None | $223.87 | $309.03 | $446.68 |
Denver HMP Setting Facility Modifier None Typical Low $213.80 Median $302.00 Typical High $436.52 | Facility | None | $213.80 | $302.00 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $524.81 | Professional | None | $199.53 | $323.59 | $524.81 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $302.00 Typical High $645.65 | Facility | None | $281.84 | $302.00 | $645.65 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $223.87 Typical High $302.00 | Professional | None | $125.89 | $223.87 | $302.00 |
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 $229.09 Median $323.59 Typical High $549.54 | Professional | None | $229.09 | $323.59 | $549.54 |
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 $107.15 Median $128.82 Typical High $151.36 | Professional | 52 · Reduced service | $107.15 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $51.29 Typical High $60.26 | Professional | 53 · Discontinued | $42.66 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $194.98 Typical High $229.09 | Professional | 54 · Surgery only | $158.49 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $38.90 Typical High $45.71 | Professional | 55 · Aftercare only | $32.36 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $25.70 Typical High $30.20 | Professional | 56 · Pre-op care only | $21.38 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $181.97 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $147.91 | $181.97 | $213.80 |
Where Colorado sits
The same service costs 3.9 times more in Alaska than in Texas. 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
$372
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.