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 $114.82 Median $147.91 Typical High $194.98 | Professional | None | $114.82 | $147.91 | $194.98 |
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 $199.53 Typical High $309.03 | Professional | None | $138.04 | $199.53 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $218.78 Typical High $1,659.59 | Facility | None | $125.89 | $218.78 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $245.47 | Professional | None | $117.49 | $162.18 | $245.47 |
Denver HMP Setting Facility Modifier None Typical Low $114.82 Median $162.18 Typical High $263.03 | Facility | None | $114.82 | $162.18 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $269.15 | Professional | None | $125.89 | $186.21 | $269.15 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $165.96 Typical High $323.59 | Facility | None | $154.88 | $165.96 | $323.59 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $165.96 | Professional | None | $93.33 | $131.83 | $165.96 |
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 $120.23 Median $169.82 Typical High $269.15 | Professional | None | $120.23 | $169.82 | $269.15 |
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 $57.54 Median $69.18 Typical High $77.62 | Professional | 52 · Reduced service | $57.54 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $27.54 Typical High $30.90 | Professional | 53 · Discontinued | $22.91 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $104.71 Typical High $114.82 | Professional | 54 · Surgery only | $85.11 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $20.89 Typical High $23.44 | Professional | 55 · Aftercare only | $16.98 | $20.89 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.80 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.48 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $97.72 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $79.43 | $97.72 | $107.15 |
Where Colorado sits
The same service costs 4.0 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
$186
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.