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 $134.90 Median $208.93 Typical High $275.42 | Professional | None | $134.90 | $208.93 | $275.42 |
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 $162.18 Median $269.15 Typical High $478.63 | Professional | None | $162.18 | $269.15 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $331.13 Typical High $1,659.59 | Facility | None | $213.80 | $331.13 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $354.81 | Professional | None | $141.25 | $218.78 | $354.81 |
Denver HMP Setting Facility Modifier None Typical Low $134.90 Median $234.42 Typical High $389.05 | Facility | None | $134.90 | $234.42 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $407.38 | Professional | None | $151.36 | $263.03 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $263.03 Typical High $501.19 | Facility | None | $234.42 | $263.03 | $501.19 |
Select Health Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $234.42 | Professional | None | $109.65 | $158.49 | $234.42 |
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 $144.54 Median $229.09 Typical High $380.19 | Professional | None | $144.54 | $229.09 | $380.19 |
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 $97.72 Typical High $117.49 | Professional | 52 · Reduced service | $66.07 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $38.90 Typical High $46.77 | Professional | 53 · Discontinued | $26.92 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $144.54 Typical High $177.83 | Professional | 54 · Surgery only | $100.00 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $29.51 Typical High $35.48 | Professional | 55 · Aftercare only | $19.95 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $19.50 Typical High $23.44 | Professional | 56 · Pre-op care only | $13.49 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $134.90 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $93.33 | $134.90 | $165.96 |
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· 16th of 51
$257
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.