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 $346.74 Median $3,235.94 Typical High $8,912.51 | Facility | None | $346.74 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $446.68 | Professional | None | $218.78 | $302.00 | $446.68 |
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 $257.04 Median $416.87 Typical High $776.25 | Professional | None | $257.04 | $416.87 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,698.24 | Facility | None | $50.12 | $66.07 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $549.54 | Professional | None | $257.04 | $380.19 | $549.54 |
Denver HMP Setting Facility Modifier None Typical Low $218.78 Median $346.74 Typical High $549.54 | Facility | None | $218.78 | $346.74 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $588.84 | Professional | None | $223.87 | $346.74 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $398.11 Typical High $724.44 | Facility | None | $346.74 | $398.11 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $245.47 Typical High $346.74 | Professional | None | $138.04 | $245.47 | $346.74 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,174.90 Typical High $2,951.21 | Facility | None | $489.78 | $1,174.90 | $2,951.21 |
United Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $660.69 | Professional | None | $251.19 | $416.87 | $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 $109.65 Median $144.54 Typical High $173.78 | Professional | 52 · Reduced service | $109.65 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $57.54 Typical High $69.18 | Professional | 53 · Discontinued | $43.65 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $213.80 Typical High $263.03 | Professional | 54 · Surgery only | $165.96 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $43.65 Typical High $52.48 | Professional | 55 · Aftercare only | $33.11 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $28.84 Typical High $34.67 | Professional | 56 · Pre-op care only | $21.88 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $199.53 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $154.88 | $199.53 | $245.47 |
Where Colorado sits
The same service costs 4.1 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· 10th of 51
$447
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.