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 $141.25 Median $223.87 Typical High $288.40 | Professional | None | $141.25 | $223.87 | $288.40 |
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 $169.82 Median $281.84 Typical High $501.19 | Professional | None | $169.82 | $281.84 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $380.19 Typical High $1,659.59 | Facility | None | $251.19 | $380.19 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $380.19 | Professional | None | $147.91 | $234.42 | $380.19 |
Denver HMP Setting Facility Modifier None Typical Low $141.25 Median $251.19 Typical High $446.68 | Facility | None | $141.25 | $251.19 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $295.12 Typical High $478.63 | Professional | None | $169.82 | $295.12 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $269.15 Median $309.03 Typical High $588.84 | Facility | None | $269.15 | $309.03 | $588.84 |
Select Health Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $281.84 | Professional | None | $117.49 | $173.78 | $281.84 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $407.38 | Professional | None | $147.91 | $245.47 | $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 $70.79 Median $104.71 Typical High $125.89 | Professional | 52 · Reduced service | $70.79 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $41.69 Typical High $50.12 | Professional | 53 · Discontinued | $28.18 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $154.88 Typical High $190.55 | Professional | 54 · Surgery only | $107.15 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.90 Typical High $38.02 | Professional | 55 · Aftercare only | $21.38 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.89 Typical High $25.12 | Professional | 56 · Pre-op care only | $14.13 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $144.54 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $100.00 | $144.54 | $177.83 |
Where Colorado sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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
$269
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.