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 $218.78 Median $3,090.30 Typical High $7,762.47 | Facility | None | $218.78 | $3,090.30 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $380.19 | Professional | None | $147.91 | $239.88 | $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 $173.78 Median $316.23 Typical High $549.54 | Professional | None | $173.78 | $316.23 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $239.88 Typical High $426.58 | Facility | None | $52.48 | $239.88 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $371.54 | Professional | None | $173.78 | $251.19 | $371.54 |
Denver HMP Setting Facility Modifier None Typical Low $147.91 Median $251.19 Typical High $389.05 | Facility | None | $147.91 | $251.19 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $467.74 | Professional | None | $158.49 | $251.19 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $263.03 Median $288.40 Typical High $575.44 | Facility | None | $263.03 | $288.40 | $575.44 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $275.42 | Professional | None | $91.20 | $162.18 | $275.42 |
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 $162.18 Median $269.15 Typical High $436.52 | Professional | None | $162.18 | $269.15 | $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 $74.13 Median $102.33 Typical High $134.90 | Professional | 52 · Reduced service | $74.13 | $102.33 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $40.74 Typical High $53.70 | Professional | 53 · Discontinued | $29.51 | $40.74 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $151.36 Typical High $204.17 | Professional | 54 · Surgery only | $112.20 | $151.36 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $30.20 Typical High $40.74 | Professional | 55 · Aftercare only | $22.39 | $30.20 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $20.42 Typical High $26.92 | Professional | 56 · Pre-op care only | $14.79 | $20.42 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $141.25 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $104.71 | $141.25 | $190.55 |
Where Colorado sits
The same service costs 3.4 times more in Alaska than in Maryland. 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
$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.