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 $147.91 Median $3,235.94 Typical High $7,762.47 | Facility | None | $147.91 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $234.42 | Professional | None | $117.49 | $147.91 | $234.42 |
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 $141.25 Median $194.98 Typical High $295.12 | Professional | None | $141.25 | $194.98 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $104.71 Typical High $724.44 | Facility | None | $64.57 | $104.71 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $251.19 | Professional | None | $144.54 | $177.83 | $251.19 |
Denver HMP Setting Facility Modifier None Typical Low $117.49 Median $147.91 Typical High $275.42 | Facility | None | $117.49 | $147.91 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $269.15 | Professional | None | $128.82 | $190.55 | $269.15 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $158.49 Typical High $331.13 | Facility | None | $117.49 | $158.49 | $331.13 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $162.18 | Professional | None | $120.23 | $138.04 | $162.18 |
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 $138.04 Median $190.55 Typical High $295.12 | Professional | None | $138.04 | $190.55 | $295.12 |
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 $58.88 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $58.88 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $23.44 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $112.20 Typical High $112.20 | Professional | 54 · Surgery only | $89.13 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $17.78 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $11.75 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $104.71 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $83.18 | $104.71 | $104.71 |
Where Colorado sits
The same service costs 3.9 times more in Alaska than in Florida. 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
$191
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.