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 $263.03 Median $2,570.40 Typical High $7,585.78 | Facility | None | $263.03 | $2,570.40 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $457.09 | Professional | None | $204.17 | $295.12 | $457.09 |
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 $239.88 Median $398.11 Typical High $724.44 | Professional | None | $239.88 | $398.11 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $263.03 Typical High $478.63 | Facility | None | $52.48 | $263.03 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $478.63 | Professional | None | $229.09 | $316.23 | $478.63 |
Denver HMP Setting Facility Modifier None Typical Low $204.17 Median $323.59 Typical High $467.74 | Facility | None | $204.17 | $323.59 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $549.54 | Professional | None | $208.93 | $323.59 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $323.59 Median $346.74 Typical High $676.08 | Facility | None | $323.59 | $346.74 | $676.08 |
Select Health Setting Professional Modifier None Typical Low $123.03 Median $218.78 Typical High $323.59 | Professional | None | $123.03 | $218.78 | $323.59 |
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 $218.78 Median $331.13 Typical High $537.03 | Professional | None | $218.78 | $331.13 | $537.03 |
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 $102.33 Median $134.90 Typical High $162.18 | Professional | 52 · Reduced service | $102.33 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $53.70 Typical High $64.57 | Professional | 53 · Discontinued | $40.74 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $204.17 Typical High $239.88 | Professional | 54 · Surgery only | $154.88 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $40.74 Typical High $48.98 | Professional | 55 · Aftercare only | $30.90 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $26.92 Typical High $32.36 | Professional | 56 · Pre-op care only | $20.42 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $190.55 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $144.54 | $190.55 | $229.09 |
Where Colorado sits
The same service costs 3.7 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· 11th of 51
$380
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.