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 $218.78 Median $3,311.31 Typical High $8,709.64 | Facility | None | $218.78 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $239.88 | Professional | None | $151.36 | $173.78 | $239.88 |
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 $165.96 Median $239.88 Typical High $354.81 | Professional | None | $165.96 | $239.88 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $151.36 Typical High $275.42 | Facility | None | $52.48 | $151.36 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $288.40 | Professional | None | $144.54 | $190.55 | $288.40 |
Denver HMP Setting Facility Modifier None Typical Low $151.36 Median $194.98 Typical High $338.84 | Facility | None | $151.36 | $194.98 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $316.23 | Professional | None | $173.78 | $234.42 | $316.23 |
Select Health Setting Facility Modifier None Typical Low $181.97 Median $194.98 Typical High $380.19 | Facility | None | $181.97 | $194.98 | $380.19 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $223.87 | Professional | None | $147.91 | $181.97 | $223.87 |
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 $147.91 Median $190.55 Typical High $323.59 | Professional | None | $147.91 | $190.55 | $323.59 |
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 $75.86 Median $81.28 Typical High $87.10 | Professional | 52 · Reduced service | $75.86 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $32.36 Typical High $34.67 | Professional | 53 · Discontinued | $30.20 | $32.36 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $123.03 Typical High $128.82 | Professional | 54 · Surgery only | $112.20 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $24.55 Typical High $25.70 | Professional | 55 · Aftercare only | $22.39 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.22 Typical High $17.38 | Professional | 56 · Pre-op care only | $15.14 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $114.82 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $104.71 | $114.82 | $120.23 |
Where Colorado sits
The same service costs 4.9 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
$214
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.