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 $112.20 Median $162.18 Typical High $194.98 | Professional | None | $112.20 | $162.18 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $223.87 Typical High $371.54 | Professional | None | $134.90 | $223.87 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $162.18 Typical High $295.12 | Facility | None | $52.48 | $162.18 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $275.42 | Professional | None | $117.49 | $173.78 | $275.42 |
Denver HMP Setting Facility Modifier None Typical Low $112.20 Median $181.97 Typical High $316.23 | Facility | None | $112.20 | $181.97 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $323.59 | Professional | None | $125.89 | $213.80 | $323.59 |
Select Health Setting Facility Modifier None Typical Low $190.55 Median $199.53 Typical High $407.38 | Facility | None | $190.55 | $199.53 | $407.38 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $190.55 | Professional | None | $91.20 | $128.82 | $190.55 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,995.26 | Facility | None | $239.88 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $302.00 | Professional | None | $120.23 | $181.97 | $302.00 |
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 $77.62 Typical High $91.20 | Professional | 52 · Reduced service | $56.23 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $30.90 Typical High $36.31 | Professional | 53 · Discontinued | $22.39 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $114.82 Typical High $138.04 | Professional | 54 · Surgery only | $83.18 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $23.44 Typical High $27.54 | Professional | 55 · Aftercare only | $16.60 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.49 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.22 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $107.15 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $77.62 | $107.15 | $128.82 |
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· 17th of 51
$204
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.