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 $123.03 Median $173.78 Typical High $257.04 | Professional | None | $123.03 | $173.78 | $257.04 |
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 $147.91 Median $239.88 Typical High $446.68 | Professional | None | $147.91 | $239.88 | $446.68 |
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 $138.04 Median $190.55 Typical High $288.40 | Professional | None | $138.04 | $190.55 | $288.40 |
Denver HMP Setting Facility Modifier None Typical Low $125.89 Median $190.55 Typical High $281.84 | Facility | None | $125.89 | $190.55 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $331.13 | Professional | None | $125.89 | $194.98 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $208.93 Typical High $407.38 | Facility | None | $194.98 | $208.93 | $407.38 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $128.82 Typical High $194.98 | Professional | None | $72.44 | $128.82 | $194.98 |
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 $134.90 Median $208.93 Typical High $346.74 | Professional | None | $134.90 | $208.93 | $346.74 |
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 $63.10 Median $83.18 Typical High $100.00 | Professional | 52 · Reduced service | $63.10 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $33.11 Typical High $39.81 | Professional | 53 · Discontinued | $25.12 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $125.89 Typical High $147.91 | Professional | 54 · Surgery only | $93.33 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $25.12 Typical High $30.20 | Professional | 55 · Aftercare only | $18.62 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.60 Typical High $19.95 | Professional | 56 · Pre-op care only | $12.59 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $117.49 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $87.10 | $117.49 | $138.04 |
Where Colorado sits
The same service costs 3.3 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
$240
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.