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 $288.40 Median $3,235.94 Typical High $9,120.11 | Facility | None | $288.40 | $3,235.94 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $389.05 | Professional | None | $158.49 | $245.47 | $389.05 |
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 $177.83 Median $229.09 Typical High $380.19 | Professional | None | $177.83 | $229.09 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $389.05 Typical High $1,659.59 | Facility | None | $263.03 | $389.05 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $426.58 | Professional | None | $154.88 | $239.88 | $426.58 |
Denver HMP Setting Facility Modifier None Typical Low $186.21 Median $331.13 Typical High $467.74 | Facility | None | $186.21 | $331.13 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $275.42 Typical High $446.68 | Professional | None | $165.96 | $275.42 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $316.23 Typical High $616.60 | Facility | None | $275.42 | $316.23 | $616.60 |
Select Health Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $288.40 | Professional | None | $95.50 | $162.18 | $288.40 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $4,897.79 | Facility | None | $676.08 | $1,412.54 | $4,897.79 |
United Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $501.19 | Professional | None | $162.18 | $281.84 | $501.19 |
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 $120.23 Typical High $165.96 | Professional | 52 · Reduced service | $93.33 | $120.23 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $47.86 Typical High $66.07 | Professional | 53 · Discontinued | $37.15 | $47.86 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $177.83 Typical High $245.47 | Professional | 54 · Surgery only | $138.04 | $177.83 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $36.31 Typical High $48.98 | Professional | 55 · Aftercare only | $28.18 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $23.99 Typical High $33.11 | Professional | 56 · Pre-op care only | $18.62 | $23.99 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $165.96 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $128.82 | $165.96 | $229.09 |
Where Colorado sits
The same service costs 3.8 times more in Wyoming 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· 15th of 51
$331
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.