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 $186.21 Median $251.19 Typical High $281.84 | Professional | None | $186.21 | $251.19 | $281.84 |
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 $218.78 Median $309.03 Typical High $457.09 | Professional | None | $218.78 | $309.03 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $794.33 Typical High $2,187.76 | Facility | None | $562.34 | $794.33 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $436.52 | Professional | None | $204.17 | $275.42 | $436.52 |
Denver HMP Setting Facility Modifier None Typical Low $186.21 Median $269.15 Typical High $467.74 | Facility | None | $186.21 | $269.15 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $467.74 | Professional | None | $223.87 | $323.59 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $524.81 Typical High $812.83 | Facility | None | $281.84 | $524.81 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $281.84 | Professional | None | $190.55 | $239.88 | $281.84 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,122.02 Typical High $2,884.03 | Facility | None | $489.78 | $1,122.02 | $2,884.03 |
United Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $478.63 | Professional | None | $204.17 | $269.15 | $478.63 |
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 $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $93.33 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $38.02 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $186.21 Typical High $190.55 | Professional | 54 · Surgery only | $141.25 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $37.15 Typical High $38.02 | Professional | 55 · Aftercare only | $28.18 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $18.62 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $173.78 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $131.83 | $173.78 | $177.83 |
Where Colorado sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 20th of 51
$309
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.