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 $1,258.93 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $281.84 | Professional | None | $104.71 | $154.88 | $281.84 |
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 $141.25 Median $229.09 Typical High $380.19 | Professional | None | $141.25 | $229.09 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $199.53 Typical High $2,691.53 | Facility | None | $114.82 | $199.53 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $281.84 | Professional | None | $131.83 | $177.83 | $281.84 |
Denver HMP Setting Facility Modifier None Typical Low $104.71 Median $162.18 Typical High $223.87 | Facility | None | $104.71 | $162.18 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $295.12 | Professional | None | $112.20 | $181.97 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $141.25 Median $165.96 Typical High $354.81 | Facility | None | $141.25 | $165.96 | $354.81 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $165.96 Typical High $323.59 | Professional | None | $72.44 | $165.96 | $323.59 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $331.13 | Professional | None | $134.90 | $186.21 | $331.13 |
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 $52.48 Median $74.13 Typical High $77.62 | Professional | 52 · Reduced service | $52.48 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $29.51 Typical High $30.90 | Professional | 53 · Discontinued | $20.89 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $112.20 Typical High $114.82 | Professional | 54 · Surgery only | $77.62 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $22.39 Typical High $22.91 | Professional | 55 · Aftercare only | $15.49 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $14.79 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.47 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $104.71 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $72.44 | $104.71 | $107.15 |
Where Colorado sits
The same service costs 3.6 times more in Wisconsin 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· 11th of 51
$229
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.