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 $194.98 Median $3,235.94 Typical High $7,762.47 | Facility | None | $194.98 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $323.59 | Professional | None | $117.49 | $181.97 | $323.59 |
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 $131.83 Median $186.21 Typical High $275.42 | Professional | None | $131.83 | $186.21 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $165.96 Typical High $302.00 | Facility | None | $52.48 | $165.96 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $323.59 | Professional | None | $125.89 | $194.98 | $323.59 |
Denver HMP Setting Facility Modifier None Typical Low $134.90 Median $213.80 Typical High $316.23 | Facility | None | $134.90 | $213.80 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $331.13 | Professional | None | $114.82 | $194.98 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $208.93 Typical High $416.87 | Facility | None | $194.98 | $208.93 | $416.87 |
Select Health Setting Professional Modifier None Typical Low $74.13 Median $194.98 Typical High $380.19 | Professional | None | $74.13 | $194.98 | $380.19 |
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 $123.03 Median $208.93 Typical High $363.08 | Professional | None | $123.03 | $208.93 | $363.08 |
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 $66.07 Median $91.20 Typical High $112.20 | Professional | 52 · Reduced service | $66.07 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $36.31 Typical High $44.67 | Professional | 53 · Discontinued | $26.30 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $134.90 Typical High $165.96 | Professional | 54 · Surgery only | $100.00 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $26.92 Typical High $33.88 | Professional | 55 · Aftercare only | $19.95 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $18.20 Typical High $22.39 | Professional | 56 · Pre-op care only | $13.18 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $125.89 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $93.33 | $125.89 | $154.88 |
Where Colorado sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 13th of 51
$224
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.