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 $141.25 Median $186.21 Typical High $281.84 | Professional | None | $141.25 | $186.21 | $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 $162.18 Median $263.03 Typical High $478.63 | Professional | None | $162.18 | $263.03 | $478.63 |
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 $154.88 Median $213.80 Typical High $316.23 | Professional | None | $154.88 | $213.80 | $316.23 |
Denver HMP Setting Facility Modifier None Typical Low $141.25 Median $213.80 Typical High $309.03 | Facility | None | $141.25 | $213.80 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $363.08 | Professional | None | $138.04 | $218.78 | $363.08 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $213.80 Typical High $446.68 | Facility | None | $199.53 | $213.80 | $446.68 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $144.54 Typical High $213.80 | Professional | None | $81.28 | $144.54 | $213.80 |
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 $151.36 Median $223.87 Typical High $380.19 | Professional | None | $151.36 | $223.87 | $380.19 |
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 $70.79 Median $91.20 Typical High $107.15 | Professional | 52 · Reduced service | $70.79 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $36.31 Typical High $43.65 | Professional | 53 · Discontinued | $28.18 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $134.90 Typical High $162.18 | Professional | 54 · Surgery only | $104.71 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $26.92 Typical High $32.36 | Professional | 55 · Aftercare only | $20.89 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $18.20 Typical High $21.38 | Professional | 56 · Pre-op care only | $14.13 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $125.89 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $97.72 | $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· 11th 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.