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 $1,258.93 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $354.81 Typical High $512.86 | Professional | None | $223.87 | $354.81 | $512.86 |
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 $263.03 Median $457.09 Typical High $812.83 | Professional | None | $263.03 | $457.09 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $489.78 Typical High $2,187.76 | Facility | None | $281.84 | $489.78 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $537.03 | Professional | None | $239.88 | $371.54 | $537.03 |
Denver HMP Setting Facility Modifier None Typical Low $223.87 Median $354.81 Typical High $562.34 | Facility | None | $223.87 | $354.81 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $676.08 | Professional | None | $239.88 | $380.19 | $676.08 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $398.11 Typical High $851.14 | Facility | None | $346.74 | $398.11 | $851.14 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $245.47 Typical High $407.38 | Professional | None | $138.04 | $245.47 | $407.38 |
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 $239.88 Median $389.05 Typical High $660.69 | Professional | None | $239.88 | $389.05 | $660.69 |
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 $112.20 Median $151.36 Typical High $194.98 | Professional | 52 · Reduced service | $112.20 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $60.26 Typical High $77.62 | Professional | 53 · Discontinued | $44.67 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $223.87 Typical High $295.12 | Professional | 54 · Surgery only | $165.96 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $44.67 Typical High $58.88 | Professional | 55 · Aftercare only | $33.88 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $30.20 Typical High $38.90 | Professional | 56 · Pre-op care only | $22.39 | $30.20 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $208.93 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $154.88 | $208.93 | $275.42 |
Where Colorado sits
The same service costs 3.5 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· 10th of 51
$457
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.