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 $295.12 Median $323.59 Typical High $478.63 | Professional | None | $295.12 | $323.59 | $478.63 |
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 $331.13 Median $489.78 Typical High $724.44 | Professional | None | $331.13 | $489.78 | $724.44 |
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 $275.42 Median $363.08 Typical High $549.54 | Professional | None | $275.42 | $363.08 | $549.54 |
Denver HMP Setting Facility Modifier None Typical Low $302.00 Median $389.05 Typical High $660.69 | Facility | None | $302.00 | $389.05 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $630.96 | Professional | None | $346.74 | $457.09 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $354.81 Typical High $741.31 | Facility | None | $208.93 | $354.81 | $741.31 |
Select Health Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $446.68 | Professional | None | $302.00 | $354.81 | $446.68 |
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 $281.84 Median $371.54 Typical High $616.60 | Professional | None | $281.84 | $371.54 | $616.60 |
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 $151.36 Median $158.49 Typical High $162.18 | Professional | 52 · Reduced service | $151.36 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $63.10 Typical High $64.57 | Professional | 53 · Discontinued | $60.26 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $234.42 Typical High $245.47 | Professional | 54 · Surgery only | $229.09 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $46.77 Typical High $48.98 | Professional | 55 · Aftercare only | $45.71 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $31.62 Typical High $32.36 | Professional | 56 · Pre-op care only | $30.20 | $31.62 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $218.78 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $213.80 | $218.78 | $229.09 |
Where Colorado sits
The same service costs 5.8 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· 17th of 51
$417
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.