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 $1,258.93 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $1,258.93 | Professional | None | $208.93 | $295.12 | $1,258.93 |
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 $251.19 Median $398.11 Typical High $645.65 | Professional | None | $251.19 | $398.11 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $426.58 Typical High $2,187.76 | Facility | None | $245.47 | $426.58 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $537.03 | Professional | None | $251.19 | $346.74 | $537.03 |
Denver HMP Setting Facility Modifier None Typical Low $208.93 Median $331.13 Typical High $489.78 | Facility | None | $208.93 | $331.13 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $331.13 Typical High $512.86 | Professional | None | $208.93 | $331.13 | $512.86 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $316.23 Typical High $630.96 | Facility | None | $295.12 | $316.23 | $630.96 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $302.00 Typical High $588.84 | Professional | None | $131.83 | $302.00 | $588.84 |
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 $257.04 Median $371.54 Typical High $630.96 | Professional | None | $257.04 | $371.54 | $630.96 |
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 $102.33 Median $144.54 Typical High $151.36 | Professional | 52 · Reduced service | $102.33 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $58.88 Typical High $60.26 | Professional | 53 · Discontinued | $41.69 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $218.78 Typical High $223.87 | Professional | 54 · Surgery only | $154.88 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $43.65 Typical High $44.67 | Professional | 55 · Aftercare only | $30.90 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $29.51 Typical High $30.20 | Professional | 56 · Pre-op care only | $20.89 | $29.51 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $204.17 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $144.54 | $204.17 | $208.93 |
Where Colorado sits
The same service costs 3.7 times more in Wisconsin than in Texas. 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· 15th of 51
$407
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.