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 $169.82 Median $229.09 Typical High $309.03 | Professional | None | $169.82 | $229.09 | $309.03 |
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 $204.17 Median $316.23 Typical High $489.78 | Professional | None | $204.17 | $316.23 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $338.84 Typical High $2,691.53 | Facility | None | $194.98 | $338.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $380.19 | Professional | None | $177.83 | $251.19 | $380.19 |
Denver HMP Setting Facility Modifier None Typical Low $169.82 Median $245.47 Typical High $398.11 | Facility | None | $169.82 | $245.47 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $426.58 | Professional | None | $186.21 | $295.12 | $426.58 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $257.04 Typical High $512.86 | Facility | None | $239.88 | $257.04 | $512.86 |
Select Health Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $245.47 | Professional | None | $141.25 | $199.53 | $245.47 |
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 $181.97 Median $263.03 Typical High $416.87 | Professional | None | $181.97 | $263.03 | $416.87 |
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 $85.11 Median $107.15 Typical High $120.23 | Professional | 52 · Reduced service | $85.11 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $42.66 Typical High $48.98 | Professional | 53 · Discontinued | $33.88 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $162.18 Typical High $181.97 | Professional | 54 · Surgery only | $128.82 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $32.36 Typical High $36.31 | Professional | 55 · Aftercare only | $25.70 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.38 Typical High $23.99 | Professional | 56 · Pre-op care only | $16.98 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $151.36 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $120.23 | $151.36 | $169.82 |
Where Colorado sits
The same service costs 3.8 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
$288
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.