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 $134.90 Median $177.83 Typical High $281.84 | Professional | None | $134.90 | $177.83 | $281.84 |
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 $154.88 Median $257.04 Typical High $467.74 | Professional | None | $154.88 | $257.04 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $165.96 Typical High $302.00 | Facility | None | $52.48 | $165.96 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $309.03 | Professional | None | $147.91 | $204.17 | $309.03 |
Denver HMP Setting Facility Modifier None Typical Low $134.90 Median $204.17 Typical High $309.03 | Facility | None | $134.90 | $204.17 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $354.81 | Professional | None | $131.83 | $208.93 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $204.17 Median $218.78 Typical High $436.52 | Facility | None | $204.17 | $218.78 | $436.52 |
Select Health Setting Professional Modifier None Typical Low $77.62 Median $138.04 Typical High $208.93 | Professional | None | $77.62 | $138.04 | $208.93 |
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 $144.54 Median $223.87 Typical High $371.54 | Professional | None | $144.54 | $223.87 | $371.54 |
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 $67.61 Median $89.13 Typical High $107.15 | Professional | 52 · Reduced service | $67.61 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $35.48 Typical High $42.66 | Professional | 53 · Discontinued | $26.92 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $134.90 Typical High $162.18 | Professional | 54 · Surgery only | $100.00 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $26.92 Typical High $32.36 | Professional | 55 · Aftercare only | $19.95 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $17.78 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.49 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $125.89 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $93.33 | $125.89 | $151.36 |
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
$257
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.