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 $151.36 Median $3,162.28 Typical High $7,762.47 | Facility | None | $151.36 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $281.84 | Professional | None | $87.10 | $147.91 | $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 $131.83 Median $223.87 Typical High $407.38 | Professional | None | $131.83 | $223.87 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $162.18 Typical High $295.12 | Facility | None | $52.48 | $162.18 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $281.84 | Professional | None | $131.83 | $194.98 | $281.84 |
Denver HMP Setting Facility Modifier None Typical Low $87.10 Median $186.21 Typical High $309.03 | Facility | None | $87.10 | $186.21 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $331.13 | Professional | None | $125.89 | $194.98 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $213.80 Typical High $407.38 | Facility | None | $194.98 | $213.80 | $407.38 |
Select Health Setting Professional Modifier None Typical Low $74.13 Median $131.83 Typical High $194.98 | Professional | None | $74.13 | $131.83 | $194.98 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,995.26 | Facility | None | $239.88 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $125.89 Median $208.93 Typical High $354.81 | Professional | None | $125.89 | $208.93 | $354.81 |
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 $43.65 Median $74.13 Typical High $89.13 | Professional | 52 · Reduced service | $43.65 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $30.20 Typical High $35.48 | Professional | 53 · Discontinued | $17.78 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $112.20 Typical High $131.83 | Professional | 54 · Surgery only | $66.07 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $22.39 Typical High $26.30 | Professional | 55 · Aftercare only | $13.18 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $14.79 Typical High $17.78 | Professional | 56 · Pre-op care only | $8.71 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $104.71 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $61.66 | $104.71 | $123.03 |
Where Colorado sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$234
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.