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 $151.36 Median $204.17 Typical High $263.03 | Professional | None | $151.36 | $204.17 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $295.12 Typical High $501.19 | Professional | None | $181.97 | $295.12 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $331.13 Typical High $1,659.59 | Facility | None | $204.17 | $331.13 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $346.74 | Professional | None | $151.36 | $218.78 | $346.74 |
Denver HMP Setting Facility Modifier None Typical Low $151.36 Median $218.78 Typical High $346.74 | Facility | None | $151.36 | $218.78 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $398.11 | Professional | None | $173.78 | $263.03 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $263.03 Typical High $501.19 | Facility | None | $239.88 | $263.03 | $501.19 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $239.88 | Professional | None | $147.91 | $190.55 | $239.88 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,122.02 Typical High $2,884.03 | Facility | None | $489.78 | $1,122.02 | $2,884.03 |
United Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $398.11 | Professional | None | $158.49 | $229.09 | $398.11 |
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 $75.86 Median $97.72 Typical High $109.65 | Professional | 52 · Reduced service | $75.86 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $38.90 Typical High $43.65 | Professional | 53 · Discontinued | $30.20 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $144.54 Typical High $165.96 | Professional | 54 · Surgery only | $112.20 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $28.84 Typical High $33.11 | Professional | 55 · Aftercare only | $22.39 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.50 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.14 | $19.50 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $134.90 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $104.71 | $134.90 | $154.88 |
Where Colorado sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 14th of 51
$275
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.