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 $173.78 Median $3,235.94 Typical High $8,709.64 | Facility | None | $173.78 | $3,235.94 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $218.78 | Professional | None | $117.49 | $151.36 | $218.78 |
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 $125.89 Median $169.82 Typical High $288.40 | Professional | None | $125.89 | $169.82 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $123.03 Typical High $223.87 | Facility | None | $52.48 | $123.03 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $229.09 | Professional | None | $114.82 | $151.36 | $229.09 |
Denver HMP Setting Facility Modifier None Typical Low $138.04 Median $177.83 Typical High $269.15 | Facility | None | $138.04 | $177.83 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $229.09 | Professional | None | $120.23 | $173.78 | $229.09 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $158.49 Typical High $316.23 | Facility | None | $147.91 | $158.49 | $316.23 |
Select Health Setting Professional Modifier None Typical Low $74.13 Median $123.03 Typical High $154.88 | Professional | None | $74.13 | $123.03 | $154.88 |
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 $117.49 Median $165.96 Typical High $269.15 | Professional | None | $117.49 | $165.96 | $269.15 |
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 $64.57 Median $70.79 Typical High $87.10 | Professional | 52 · Reduced service | $64.57 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $28.18 Typical High $34.67 | Professional | 53 · Discontinued | $25.70 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $104.71 Typical High $128.82 | Professional | 54 · Surgery only | $97.72 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $20.89 Typical High $25.70 | Professional | 55 · Aftercare only | $19.50 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $14.13 Typical High $17.38 | Professional | 56 · Pre-op care only | $12.88 | $14.13 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $97.72 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $91.20 | $97.72 | $120.23 |
Where Colorado sits
The same service costs 4.1 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
$182
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.