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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $537.03 | Professional | None | $275.42 | $346.74 | $537.03 |
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 $323.59 Median $457.09 Typical High $776.25 | Professional | None | $323.59 | $457.09 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $398.11 Typical High $1,659.59 | Facility | None | $263.03 | $398.11 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $524.81 | Professional | None | $295.12 | $371.54 | $524.81 |
Denver HMP Setting Facility Modifier None Typical Low $288.40 Median $407.38 Typical High $512.86 | Facility | None | $288.40 | $407.38 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $416.87 Typical High $616.60 | Professional | None | $257.04 | $416.87 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $323.59 Median $354.81 Typical High $741.31 | Facility | None | $323.59 | $354.81 | $741.31 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $354.81 | Professional | None | $169.82 | $302.00 | $354.81 |
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 $295.12 Median $407.38 Typical High $630.96 | Professional | None | $295.12 | $407.38 | $630.96 |
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 $138.04 Median $154.88 Typical High $177.83 | Professional | 52 · Reduced service | $138.04 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $61.66 Typical High $70.79 | Professional | 53 · Discontinued | $54.95 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $234.42 Typical High $269.15 | Professional | 54 · Surgery only | $208.93 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $46.77 Typical High $53.70 | Professional | 55 · Aftercare only | $41.69 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.20 Typical High $35.48 | Professional | 56 · Pre-op care only | $27.54 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $218.78 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $194.98 | $218.78 | $251.19 |
Where Colorado sits
The same service costs 4.7 times more in Alaska than in Texas. 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
$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.