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 $158.49 Median $208.93 Typical High $316.23 | Professional | None | $158.49 | $208.93 | $316.23 |
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 $181.97 Median $295.12 Typical High $537.03 | Professional | None | $181.97 | $295.12 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $323.59 Typical High $1,659.59 | Facility | None | $186.21 | $323.59 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $354.81 | Professional | None | $173.78 | $239.88 | $354.81 |
Denver HMP Setting Facility Modifier None Typical Low $158.49 Median $239.88 Typical High $346.74 | Facility | None | $158.49 | $239.88 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $407.38 | Professional | None | $154.88 | $245.47 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $239.88 Typical High $501.19 | Facility | None | $223.87 | $239.88 | $501.19 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $239.88 | Professional | None | $91.20 | $162.18 | $239.88 |
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 $169.82 Median $251.19 Typical High $426.58 | Professional | None | $169.82 | $251.19 | $426.58 |
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 $77.62 Median $102.33 Typical High $120.23 | Professional | 52 · Reduced service | $77.62 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $40.74 Typical High $48.98 | Professional | 53 · Discontinued | $31.62 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $117.49 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $30.90 Typical High $36.31 | Professional | 55 · Aftercare only | $23.44 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $20.42 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.85 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $141.25 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $109.65 | $141.25 | $169.82 |
Where Colorado sits
The same service costs 3.5 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· 11th of 51
$295
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.