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 $147.91 Median $331.13 Typical High $457.09 | Professional | None | $147.91 | $331.13 | $457.09 |
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 $169.82 Median $239.88 Typical High $354.81 | Professional | None | $169.82 | $239.88 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,071.52 Typical High $1,659.59 | Facility | None | $436.52 | $1,071.52 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $346.74 Typical High $588.84 | Professional | None | $154.88 | $346.74 | $588.84 |
Denver HMP Setting Facility Modifier None Typical Low $147.91 Median $354.81 Typical High $575.44 | Facility | None | $147.91 | $354.81 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $645.65 | Professional | None | $173.78 | $323.59 | $645.65 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $724.44 Typical High $1,230.27 | Facility | None | $288.40 | $724.44 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $389.05 | Professional | None | $144.54 | $186.21 | $389.05 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $158.49 Median $363.08 Typical High $645.65 | Professional | None | $158.49 | $363.08 | $645.65 |
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 $74.13 Median $138.04 Typical High $177.83 | Professional | 52 · Reduced service | $74.13 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $54.95 Typical High $70.79 | Professional | 53 · Discontinued | $29.51 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $204.17 Typical High $269.15 | Professional | 54 · Surgery only | $109.65 | $204.17 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $40.74 Typical High $53.70 | Professional | 55 · Aftercare only | $21.88 | $40.74 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $27.54 Typical High $35.48 | Professional | 56 · Pre-op care only | $14.79 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $190.55 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $102.33 | $190.55 | $251.19 |
Where Colorado sits
The same service costs 4.0 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· 32nd of 51
$324
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.