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 $109.65 Median $114.82 Typical High $125.89 | Professional | None | $109.65 | $114.82 | $125.89 |
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 $117.49 Median $169.82 Typical High $251.19 | Professional | None | $117.49 | $169.82 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $107.15 Typical High $194.98 | Facility | None | $52.48 | $107.15 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $204.17 | Professional | None | $107.15 | $138.04 | $204.17 |
Denver HMP Setting Facility Modifier None Typical Low $109.65 Median $141.25 Typical High $239.88 | Facility | None | $109.65 | $141.25 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $229.09 | Professional | None | $128.82 | $165.96 | $229.09 |
Select Health Setting Facility Modifier None Typical Low $128.82 Median $138.04 Typical High $269.15 | Facility | None | $128.82 | $138.04 | $269.15 |
Select Health Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $158.49 | Professional | None | $107.15 | $128.82 | $158.49 |
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 $104.71 Median $138.04 Typical High $234.42 | Professional | None | $104.71 | $138.04 | $234.42 |
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 $54.95 Median $57.54 Typical High $61.66 | Professional | 52 · Reduced service | $54.95 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.91 Typical High $25.12 | Professional | 53 · Discontinued | $21.88 | $22.91 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $87.10 Typical High $93.33 | Professional | 54 · Surgery only | $81.28 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.38 Typical High $18.62 | Professional | 55 · Aftercare only | $16.22 | $17.38 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.48 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.96 | $11.48 | $12.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $81.28 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $75.86 | $81.28 | $87.10 |
Where Colorado sits
The same service costs 4.5 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· 19th of 51
$155
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.