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 $380.19 Median $3,235.94 Typical High $7,762.47 | Facility | None | $380.19 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $478.63 | Professional | None | $269.15 | $380.19 | $478.63 |
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 $302.00 Median $426.58 Typical High $645.65 | Professional | None | $302.00 | $426.58 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $363.08 Typical High $676.08 | Facility | None | $52.48 | $363.08 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $602.56 | Professional | None | $269.15 | $380.19 | $602.56 |
Denver HMP Setting Facility Modifier None Typical Low $269.15 Median $380.19 Typical High $645.65 | Facility | None | $269.15 | $380.19 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $676.08 | Professional | None | $309.03 | $446.68 | $676.08 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $467.74 Typical High $870.96 | Facility | None | $407.38 | $467.74 | $870.96 |
Select Health Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $407.38 | Professional | None | $263.03 | $331.13 | $407.38 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,174.90 Typical High $2,951.21 | Facility | None | $489.78 | $1,174.90 | $2,951.21 |
United Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $691.83 | Professional | None | $281.84 | $389.05 | $691.83 |
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 $134.90 Median $173.78 Typical High $190.55 | Professional | 52 · Reduced service | $134.90 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $69.18 Typical High $75.86 | Professional | 53 · Discontinued | $53.70 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $263.03 Typical High $288.40 | Professional | 54 · Surgery only | $199.53 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $52.48 Typical High $57.54 | Professional | 55 · Aftercare only | $39.81 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $34.67 Typical High $38.02 | Professional | 56 · Pre-op care only | $26.92 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $245.47 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $186.21 | $245.47 | $269.15 |
Where Colorado sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 21st of 51
$427
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.