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 $158.49 Median $186.21 Typical High $234.42 | Professional | None | $158.49 | $186.21 | $234.42 |
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 $173.78 Median $251.19 Typical High $371.54 | Professional | None | $173.78 | $251.19 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $169.82 Typical High $309.03 | Facility | None | $52.48 | $169.82 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $309.03 | Professional | None | $154.88 | $204.17 | $309.03 |
Denver HMP Setting Facility Modifier None Typical Low $158.49 Median $213.80 Typical High $354.81 | Facility | None | $158.49 | $213.80 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $346.74 | Professional | None | $190.55 | $257.04 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $204.17 Median $223.87 Typical High $426.58 | Facility | None | $204.17 | $223.87 | $426.58 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $239.88 | Professional | None | $154.88 | $204.17 | $239.88 |
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 $154.88 Median $204.17 Typical High $354.81 | Professional | None | $154.88 | $204.17 | $354.81 |
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 $79.43 Median $89.13 Typical High $95.50 | Professional | 52 · Reduced service | $79.43 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $36.31 Typical High $38.02 | Professional | 53 · Discontinued | $31.62 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $134.90 Typical High $141.25 | Professional | 54 · Surgery only | $117.49 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $26.92 Typical High $28.84 | Professional | 55 · Aftercare only | $23.44 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $17.78 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.85 | $17.78 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $125.89 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $109.65 | $125.89 | $131.83 |
Where Colorado sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 18th of 51
$229
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.