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 $204.17 Median $275.42 Typical High $323.59 | Professional | None | $204.17 | $275.42 | $323.59 |
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 $234.42 Median $346.74 Typical High $630.96 | Professional | None | $234.42 | $346.74 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $331.13 Typical High $1,659.59 | Facility | None | $199.53 | $331.13 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $416.87 | Professional | None | $229.09 | $302.00 | $416.87 |
Denver HMP Setting Facility Modifier None Typical Low $204.17 Median $288.40 Typical High $416.87 | Facility | None | $204.17 | $288.40 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $295.12 Typical High $478.63 | Professional | None | $181.97 | $295.12 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $245.47 Median $281.84 Typical High $588.84 | Facility | None | $245.47 | $281.84 | $588.84 |
Select Health Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $281.84 | Professional | None | $117.49 | $208.93 | $281.84 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,995.26 | Facility | None | $239.88 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $512.86 | Professional | None | $218.78 | $309.03 | $512.86 |
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 $102.33 Median $120.23 Typical High $141.25 | Professional | 52 · Reduced service | $102.33 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $47.86 Typical High $57.54 | Professional | 53 · Discontinued | $40.74 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $181.97 Typical High $213.80 | Professional | 54 · Surgery only | $151.36 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $36.31 Typical High $42.66 | Professional | 55 · Aftercare only | $30.20 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $23.99 Typical High $28.18 | Professional | 56 · Pre-op care only | $20.42 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $169.82 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $141.25 | $169.82 | $199.53 |
Where Colorado sits
The same service costs 3.6 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· 12th of 51
$355
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.