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 $269.15 Median $3,235.94 Typical High $8,709.64 | Facility | None | $269.15 | $3,235.94 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $295.12 | Professional | None | $158.49 | $251.19 | $295.12 |
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 $257.04 Typical High $380.19 | Professional | None | $181.97 | $257.04 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,096.48 Typical High $1,659.59 | Facility | None | $478.63 | $1,096.48 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $436.52 | Professional | None | $169.82 | $263.03 | $436.52 |
Denver HMP Setting Facility Modifier None Typical Low $158.49 Median $269.15 Typical High $380.19 | Facility | None | $158.49 | $269.15 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $478.63 | Professional | None | $173.78 | $295.12 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $524.81 Typical High $1,230.27 | Facility | None | $281.84 | $524.81 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $281.84 | Professional | None | $154.88 | $190.55 | $281.84 |
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 $169.82 Median $275.42 Typical High $489.78 | Professional | None | $169.82 | $275.42 | $489.78 |
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 $77.62 Median $109.65 Typical High $134.90 | Professional | 52 · Reduced service | $77.62 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $43.65 Typical High $53.70 | Professional | 53 · Discontinued | $31.62 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $165.96 Typical High $199.53 | Professional | 54 · Surgery only | $117.49 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $33.11 Typical High $39.81 | Professional | 55 · Aftercare only | $23.44 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $21.88 Typical High $26.92 | Professional | 56 · Pre-op care only | $15.85 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $154.88 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $109.65 | $154.88 | $186.21 |
Where Colorado sits
The same service costs 4.5 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· 25th 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.