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 $234.42 Median $3,235.94 Typical High $8,912.51 | Facility | None | $234.42 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $338.84 | Professional | None | $151.36 | $234.42 | $338.84 |
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 $186.21 Median $302.00 Typical High $524.81 | Professional | None | $186.21 | $302.00 | $524.81 |
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 $177.83 Median $269.15 Typical High $436.52 | Professional | None | $177.83 | $269.15 | $436.52 |
Denver HMP Setting Facility Modifier None Typical Low $151.36 Median $234.42 Typical High $398.11 | Facility | None | $151.36 | $234.42 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $407.38 | Professional | None | $154.88 | $257.04 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $239.88 Typical High $501.19 | Facility | None | $199.53 | $239.88 | $501.19 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $239.88 Typical High $467.74 | Professional | None | $100.00 | $239.88 | $467.74 |
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 $190.55 Median $302.00 Typical High $512.86 | Professional | None | $190.55 | $302.00 | $512.86 |
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 $112.20 Typical High $123.03 | Professional | 52 · Reduced service | $75.86 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $45.71 Typical High $48.98 | Professional | 53 · Discontinued | $30.20 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $169.82 Typical High $186.21 | Professional | 54 · Surgery only | $114.82 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $33.88 Typical High $37.15 | Professional | 55 · Aftercare only | $22.91 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $22.91 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.14 | $22.91 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $158.49 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $107.15 | $158.49 | $173.78 |
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
$316
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.