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 $125.89 Median $213.80 Typical High $371.54 | Professional | None | $125.89 | $213.80 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $275.42 Typical High $457.09 | Professional | None | $158.49 | $275.42 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $363.08 Typical High $2,691.53 | Facility | None | $213.80 | $363.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $371.54 | Professional | None | $144.54 | $218.78 | $371.54 |
Denver HMP Setting Facility Modifier None Typical Low $125.89 Median $223.87 Typical High $371.54 | Facility | None | $125.89 | $223.87 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $223.87 Typical High $389.05 | Professional | None | $128.82 | $223.87 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $257.04 Typical High $478.63 | Facility | None | $223.87 | $257.04 | $478.63 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $223.87 Typical High $436.52 | Professional | None | $83.18 | $223.87 | $436.52 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $426.58 | Professional | None | $147.91 | $239.88 | $426.58 |
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 $63.10 Median $97.72 Typical High $112.20 | Professional | 52 · Reduced service | $63.10 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $39.81 Typical High $44.67 | Professional | 53 · Discontinued | $25.12 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $147.91 Typical High $169.82 | Professional | 54 · Surgery only | $95.50 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $29.51 Typical High $33.88 | Professional | 55 · Aftercare only | $19.05 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $19.95 Typical High $22.39 | Professional | 56 · Pre-op care only | $12.59 | $19.95 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $138.04 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $89.13 | $138.04 | $158.49 |
Where Colorado sits
The same service costs 3.8 times more in Wisconsin 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· 14th of 51
$295
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.