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 $165.96 Median $245.47 Typical High $263.03 | Professional | None | $165.96 | $245.47 | $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 $190.55 Median $269.15 Typical High $398.11 | Professional | None | $190.55 | $269.15 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $363.08 Typical High $1,659.59 | Facility | None | $234.42 | $363.08 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $426.58 | Professional | None | $177.83 | $263.03 | $426.58 |
Denver HMP Setting Facility Modifier None Typical Low $165.96 Median $263.03 Typical High $380.19 | Facility | None | $165.96 | $263.03 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $457.09 | Professional | None | $181.97 | $288.40 | $457.09 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $302.00 Typical High $575.44 | Facility | None | $275.42 | $302.00 | $575.44 |
Select Health Setting Professional Modifier None Typical Low $162.18 Median $199.53 Typical High $275.42 | Professional | None | $162.18 | $199.53 | $275.42 |
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 $177.83 Median $275.42 Typical High $478.63 | Professional | None | $177.83 | $275.42 | $478.63 |
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 $83.18 Median $114.82 Typical High $131.83 | Professional | 52 · Reduced service | $83.18 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $46.77 Typical High $52.48 | Professional | 53 · Discontinued | $33.11 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $173.78 Typical High $194.98 | Professional | 54 · Surgery only | $123.03 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $34.67 Typical High $38.90 | Professional | 55 · Aftercare only | $24.55 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $22.91 Typical High $26.30 | Professional | 56 · Pre-op care only | $16.60 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $162.18 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $114.82 | $162.18 | $181.97 |
Where Colorado sits
The same service costs 3.7 times more in Alaska than in Utah. 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
$282
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.