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 $208.93 Median $229.09 Typical High $371.54 | Professional | None | $208.93 | $229.09 | $371.54 |
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 $239.88 Median $346.74 Typical High $512.86 | Professional | None | $239.88 | $346.74 | $512.86 |
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 $194.98 Median $263.03 Typical High $389.05 | Professional | None | $194.98 | $263.03 | $389.05 |
Denver HMP Setting Facility Modifier None Typical Low $213.80 Median $269.15 Typical High $478.63 | Facility | None | $213.80 | $269.15 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $446.68 | Professional | None | $245.47 | $323.59 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $245.47 Typical High $512.86 | Facility | None | $208.93 | $245.47 | $512.86 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $245.47 Typical High $323.59 | Professional | None | $213.80 | $245.47 | $323.59 |
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 $199.53 Median $269.15 Typical High $446.68 | Professional | None | $199.53 | $269.15 | $446.68 |
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 $107.15 Median $112.20 Typical High $114.82 | Professional | 52 · Reduced service | $107.15 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $44.67 Typical High $45.71 | Professional | 53 · Discontinued | $43.65 | $44.67 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $165.96 Typical High $173.78 | Professional | 54 · Surgery only | $162.18 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $33.11 Typical High $34.67 | Professional | 55 · Aftercare only | $32.36 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $22.39 Typical High $22.91 | Professional | 56 · Pre-op care only | $21.38 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $154.88 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $151.36 | $154.88 | $162.18 |
Where Colorado sits
The same service costs 5.1 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· 19th of 51
$295
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.