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 $158.49 Median $3,235.94 Typical High $8,709.64 | Facility | None | $158.49 | $3,235.94 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $190.55 | Professional | None | $112.20 | $141.25 | $190.55 |
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 $114.82 Typical High $204.17 | Facility | None | $52.48 | $114.82 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $208.93 | Professional | None | $104.71 | $138.04 | $208.93 |
Denver HMP Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $263.03 | Facility | None | $125.89 | $158.49 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $218.78 | Professional | None | $120.23 | $165.96 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $138.04 Median $147.91 Typical High $295.12 | Facility | None | $138.04 | $147.91 | $295.12 |
Select Health Setting Professional Modifier None Typical Low $75.86 Median $123.03 Typical High $158.49 | Professional | None | $75.86 | $123.03 | $158.49 |
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 $109.65 Median $147.91 Typical High $251.19 | Professional | None | $109.65 | $147.91 | $251.19 |
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 $58.88 Median $70.79 Typical High $79.43 | Professional | 52 · Reduced service | $58.88 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $28.18 Typical High $31.62 | Professional | 53 · Discontinued | $23.44 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $104.71 Typical High $120.23 | Professional | 54 · Surgery only | $87.10 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $20.89 Typical High $23.99 | Professional | 55 · Aftercare only | $17.38 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $14.13 Typical High $15.85 | Professional | 56 · Pre-op care only | $11.75 | $14.13 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $97.72 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $81.28 | $97.72 | $112.20 |
Where Colorado sits
The same service costs 4.4 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· 19th of 51
$170
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.