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 $144.54 Median $218.78 Typical High $275.42 | Professional | None | $144.54 | $218.78 | $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 $177.83 Median $288.40 Typical High $489.78 | Professional | None | $177.83 | $288.40 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $331.13 Typical High $1,659.59 | Facility | None | $208.93 | $331.13 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $363.08 | Professional | None | $162.18 | $245.47 | $363.08 |
Denver HMP Setting Facility Modifier None Typical Low $144.54 Median $229.09 Typical High $398.11 | Facility | None | $144.54 | $229.09 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $416.87 | Professional | None | $162.18 | $275.42 | $416.87 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $263.03 Typical High $512.86 | Facility | None | $239.88 | $263.03 | $512.86 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $239.88 | Professional | None | $120.23 | $169.82 | $239.88 |
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 $165.96 Median $257.04 Typical High $407.38 | Professional | None | $165.96 | $257.04 | $407.38 |
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 $72.44 Median $102.33 Typical High $120.23 | Professional | 52 · Reduced service | $72.44 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $40.74 Typical High $47.86 | Professional | 53 · Discontinued | $28.84 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $154.88 Typical High $181.97 | Professional | 54 · Surgery only | $107.15 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $30.90 Typical High $36.31 | Professional | 55 · Aftercare only | $21.88 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.42 Typical High $23.99 | Professional | 56 · Pre-op care only | $14.45 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $144.54 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $100.00 | $144.54 | $169.82 |
Where Colorado sits
The same service costs 3.5 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· 18th of 51
$275
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.