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 $177.83 Median $3,235.94 Typical High $7,762.47 | Facility | None | $177.83 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $204.17 Typical High $295.12 | Professional | None | $114.82 | $204.17 | $295.12 |
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 $138.04 Median $251.19 Typical High $446.68 | Professional | None | $138.04 | $251.19 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $954.99 Typical High $1,659.59 | Facility | None | $436.52 | $954.99 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $338.84 | Professional | None | $120.23 | $208.93 | $338.84 |
Denver HMP Setting Facility Modifier None Typical Low $114.82 Median $218.78 Typical High $346.74 | Facility | None | $114.82 | $218.78 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $234.42 Typical High $380.19 | Professional | None | $131.83 | $234.42 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $407.38 Typical High $1,096.48 | Facility | None | $213.80 | $407.38 | $1,096.48 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $218.78 | Professional | None | $93.33 | $138.04 | $218.78 |
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 $123.03 Median $213.80 Typical High $354.81 | Professional | None | $123.03 | $213.80 | $354.81 |
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 $56.23 Median $89.13 Typical High $109.65 | Professional | 52 · Reduced service | $56.23 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $35.48 Typical High $44.67 | Professional | 53 · Discontinued | $22.91 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $134.90 Typical High $165.96 | Professional | 54 · Surgery only | $85.11 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $26.92 Typical High $33.11 | Professional | 55 · Aftercare only | $16.98 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $17.78 Typical High $22.39 | Professional | 56 · Pre-op care only | $11.48 | $17.78 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $125.89 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $79.43 | $125.89 | $154.88 |
Where Colorado sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 17th 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.