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 $245.47 Median $3,235.94 Typical High $8,709.64 | Facility | None | $245.47 | $3,235.94 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $309.03 | Professional | None | $158.49 | $204.17 | $309.03 |
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 $173.78 Median $234.42 Typical High $398.11 | Professional | None | $173.78 | $234.42 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $281.84 Typical High $1,659.59 | Facility | None | $162.18 | $281.84 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $323.59 | Professional | None | $158.49 | $208.93 | $323.59 |
Denver HMP Setting Facility Modifier None Typical Low $194.98 Median $251.19 Typical High $354.81 | Facility | None | $194.98 | $251.19 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $331.13 | Professional | None | $165.96 | $234.42 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $213.80 Typical High $446.68 | Facility | None | $194.98 | $213.80 | $446.68 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $213.80 | Professional | None | $100.00 | $169.82 | $213.80 |
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 $165.96 Median $229.09 Typical High $371.54 | Professional | None | $165.96 | $229.09 | $371.54 |
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 $89.13 Median $95.50 Typical High $120.23 | Professional | 52 · Reduced service | $89.13 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.90 Typical High $48.98 | Professional | 53 · Discontinued | $35.48 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $144.54 Typical High $181.97 | Professional | 54 · Surgery only | $131.83 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.84 Typical High $36.31 | Professional | 55 · Aftercare only | $26.92 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.50 Typical High $24.55 | Professional | 56 · Pre-op care only | $17.78 | $19.50 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $134.90 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $123.03 | $134.90 | $169.82 |
Where Colorado sits
The same service costs 4.0 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· 18th of 51
$257
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.