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 $229.09 Median $323.59 Typical High $371.54 | Professional | None | $229.09 | $323.59 | $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 $275.42 Median $446.68 Typical High $741.31 | Professional | None | $275.42 | $446.68 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $512.86 Typical High $2,691.53 | Facility | None | $331.13 | $512.86 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $537.03 | Professional | None | $234.42 | $331.13 | $537.03 |
Denver HMP Setting Facility Modifier None Typical Low $229.09 Median $363.08 Typical High $645.65 | Facility | None | $229.09 | $363.08 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $436.52 Typical High $660.69 | Professional | None | $251.19 | $436.52 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $389.05 Median $407.38 Typical High $831.76 | Facility | None | $389.05 | $407.38 | $831.76 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $389.05 | Professional | None | $190.55 | $263.03 | $389.05 |
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 $251.19 Median $363.08 Typical High $588.84 | Professional | None | $251.19 | $363.08 | $588.84 |
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 $114.82 Median $154.88 Typical High $181.97 | Professional | 52 · Reduced service | $114.82 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $61.66 Typical High $72.44 | Professional | 53 · Discontinued | $45.71 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $229.09 Typical High $275.42 | Professional | 54 · Surgery only | $169.82 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $45.71 Typical High $54.95 | Professional | 55 · Aftercare only | $33.88 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $30.90 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.91 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $213.80 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $158.49 | $213.80 | $257.04 |
Where Colorado sits
The same service costs 3.6 times more in Alaska than in New Jersey. 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
$398
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.