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 $162.18 Median $208.93 Typical High $257.04 | Professional | None | $162.18 | $208.93 | $257.04 |
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 $194.98 Median $295.12 Typical High $457.09 | Professional | None | $194.98 | $295.12 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $954.99 Typical High $1,659.59 | Facility | None | $436.52 | $954.99 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $346.74 | Professional | None | $169.82 | $229.09 | $346.74 |
Denver HMP Setting Facility Modifier None Typical Low $162.18 Median $229.09 Typical High $363.08 | Facility | None | $162.18 | $229.09 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $389.05 | Professional | None | $173.78 | $269.15 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $407.38 Typical High $1,096.48 | Facility | None | $223.87 | $407.38 | $1,096.48 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $281.84 | Professional | None | $131.83 | $186.21 | $281.84 |
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 $169.82 Median $245.47 Typical High $389.05 | Professional | None | $169.82 | $245.47 | $389.05 |
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 $81.28 Median $100.00 Typical High $112.20 | Professional | 52 · Reduced service | $81.28 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $39.81 Typical High $44.67 | Professional | 53 · Discontinued | $32.36 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $151.36 Typical High $165.96 | Professional | 54 · Surgery only | $120.23 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $30.20 Typical High $33.11 | Professional | 55 · Aftercare only | $23.99 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $19.95 Typical High $22.39 | Professional | 56 · Pre-op care only | $16.22 | $19.95 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $141.25 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $112.20 | $141.25 | $154.88 |
Where Colorado sits
The same service costs 4.2 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
$263
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.