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 $186.21 Median $239.88 Typical High $295.12 | Professional | None | $186.21 | $239.88 | $295.12 |
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 $223.87 Median $346.74 Typical High $549.54 | Professional | None | $223.87 | $346.74 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $512.86 Typical High $1,659.59 | Facility | None | $371.54 | $512.86 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $407.38 | Professional | None | $194.98 | $275.42 | $407.38 |
Denver HMP Setting Facility Modifier None Typical Low $186.21 Median $269.15 Typical High $446.68 | Facility | None | $186.21 | $269.15 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $478.63 | Professional | None | $204.17 | $323.59 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $269.15 Median $457.09 Typical High $575.44 | Facility | None | $269.15 | $457.09 | $575.44 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $323.59 | Professional | None | $151.36 | $213.80 | $323.59 |
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 $199.53 Median $288.40 Typical High $457.09 | Professional | None | $199.53 | $288.40 | $457.09 |
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 $93.33 Median $120.23 Typical High $134.90 | Professional | 52 · Reduced service | $93.33 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $47.86 Typical High $53.70 | Professional | 53 · Discontinued | $37.15 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $177.83 Typical High $204.17 | Professional | 54 · Surgery only | $138.04 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $35.48 Typical High $40.74 | Professional | 55 · Aftercare only | $27.54 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $23.99 Typical High $26.92 | Professional | 56 · Pre-op care only | $18.62 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $165.96 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $128.82 | $165.96 | $190.55 |
Where Colorado sits
The same service costs 4.2 times more in Alaska than in Texas. 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· 16th of 51
$316
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.