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 $354.81 Median $3,311.31 Typical High $8,709.64 | Facility | None | $354.81 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $416.87 | Professional | None | $269.15 | $309.03 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $660.69 | Professional | None | $302.00 | $446.68 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $173.78 Typical High $309.03 | Facility | None | $52.48 | $173.78 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $501.19 | Professional | None | $239.88 | $331.13 | $501.19 |
Denver HMP Setting Facility Modifier None Typical Low $275.42 Median $338.84 Typical High $630.96 | Facility | None | $275.42 | $338.84 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $588.84 | Professional | None | $323.59 | $436.52 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $346.74 Typical High $724.44 | Facility | None | $208.93 | $346.74 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $426.58 | Professional | None | $275.42 | $346.74 | $426.58 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $562.34 | Professional | None | $245.47 | $338.84 | $562.34 |
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 $138.04 Median $141.25 Typical High $154.88 | Professional | 52 · Reduced service | $138.04 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $57.54 Typical High $61.66 | Professional | 53 · Discontinued | $54.95 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $213.80 Typical High $234.42 | Professional | 54 · Surgery only | $208.93 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $42.66 Typical High $46.77 | Professional | 55 · Aftercare only | $41.69 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.84 Typical High $30.90 | Professional | 56 · Pre-op care only | $27.54 | $28.84 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $199.53 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $194.98 | $199.53 | $218.78 |
Where Colorado sits
The same service costs 5.4 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· 20th of 51
$380
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.