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 $239.88 Median $3,235.94 Typical High $7,762.47 | Facility | None | $239.88 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $380.19 | Professional | None | $154.88 | $245.47 | $380.19 |
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 $309.03 Typical High $549.54 | Professional | None | $181.97 | $309.03 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $239.88 Typical High $436.52 | Facility | None | $52.48 | $239.88 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $363.08 | Professional | None | $169.82 | $251.19 | $363.08 |
Denver HMP Setting Facility Modifier None Typical Low $154.88 Median $239.88 Typical High $389.05 | Facility | None | $154.88 | $239.88 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $457.09 | Professional | None | $162.18 | $263.03 | $457.09 |
Select Health Setting Facility Modifier None Typical Low $269.15 Median $288.40 Typical High $575.44 | Facility | None | $269.15 | $288.40 | $575.44 |
Select Health Setting Professional Modifier None Typical Low $95.50 Median $169.82 Typical High $269.15 | Professional | None | $95.50 | $169.82 | $269.15 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $436.52 | Professional | None | $165.96 | $263.03 | $436.52 |
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 $77.62 Median $102.33 Typical High $134.90 | Professional | 52 · Reduced service | $77.62 | $102.33 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $40.74 Typical High $53.70 | Professional | 53 · Discontinued | $30.90 | $40.74 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $154.88 Typical High $204.17 | Professional | 54 · Surgery only | $117.49 | $154.88 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $30.90 Typical High $40.74 | Professional | 55 · Aftercare only | $23.44 | $30.90 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.42 Typical High $26.92 | Professional | 56 · Pre-op care only | $15.49 | $20.42 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $144.54 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $109.65 | $144.54 | $190.55 |
Where Colorado sits
The same service costs 3.5 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
$302
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.