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 $269.15 Median $3,235.94 Typical High $7,762.47 | Facility | None | $269.15 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $407.38 | Professional | None | $173.78 | $269.15 | $407.38 |
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 $204.17 Median $346.74 Typical High $616.60 | Professional | None | $204.17 | $346.74 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $251.19 Typical High $457.09 | Facility | None | $52.48 | $251.19 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $407.38 | Professional | None | $190.55 | $275.42 | $407.38 |
Denver HMP Setting Facility Modifier None Typical Low $173.78 Median $281.84 Typical High $416.87 | Facility | None | $173.78 | $281.84 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $295.12 Typical High $501.19 | Professional | None | $181.97 | $295.12 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $309.03 Typical High $616.60 | Facility | None | $295.12 | $309.03 | $616.60 |
Select Health Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $295.12 | Professional | None | $107.15 | $190.55 | $295.12 |
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 $186.21 Median $295.12 Typical High $478.63 | Professional | None | $186.21 | $295.12 | $478.63 |
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 $87.10 Median $114.82 Typical High $144.54 | Professional | 52 · Reduced service | $87.10 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $45.71 Typical High $57.54 | Professional | 53 · Discontinued | $34.67 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $173.78 Typical High $218.78 | Professional | 54 · Surgery only | $128.82 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $34.67 Typical High $43.65 | Professional | 55 · Aftercare only | $25.70 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.91 Typical High $28.84 | Professional | 56 · Pre-op care only | $17.38 | $22.91 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $162.18 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $120.23 | $162.18 | $204.17 |
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
$331
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.