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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $512.86 | Professional | None | $257.04 | $380.19 | $512.86 |
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 $281.84 Median $354.81 Typical High $616.60 | Professional | None | $281.84 | $354.81 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $223.87 Typical High $524.81 | Facility | None | $52.48 | $223.87 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $660.69 | Professional | None | $257.04 | $389.05 | $660.69 |
Denver HMP Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $724.44 | Facility | None | $302.00 | $512.86 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $436.52 Typical High $691.83 | Professional | None | $263.03 | $436.52 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $269.15 Median $436.52 Typical High $954.99 | Facility | None | $269.15 | $436.52 | $954.99 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $457.09 | Professional | None | $151.36 | $263.03 | $457.09 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,862.09 | Facility | None | $239.88 | $616.60 | $1,862.09 |
United Setting Professional Modifier None Typical Low $263.03 Median $446.68 Typical High $776.25 | Professional | None | $263.03 | $446.68 | $776.25 |
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 $151.36 Median $186.21 Typical High $257.04 | Professional | 52 · Reduced service | $151.36 | $186.21 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $74.13 Typical High $102.33 | Professional | 53 · Discontinued | $60.26 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $275.42 Typical High $380.19 | Professional | 54 · Surgery only | $223.87 | $275.42 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $56.23 Typical High $77.62 | Professional | 55 · Aftercare only | $44.67 | $56.23 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $37.15 Typical High $51.29 | Professional | 56 · Pre-op care only | $30.20 | $37.15 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $257.04 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $208.93 | $257.04 | $354.81 |
Where Colorado sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 14th of 51
$479
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.