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 $128.82 Median $194.98 Typical High $323.59 | Professional | None | $128.82 | $194.98 | $323.59 |
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 $147.91 Median $208.93 Typical High $309.03 | Professional | None | $147.91 | $208.93 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $173.78 Typical High $316.23 | Facility | None | $52.48 | $173.78 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $323.59 | Professional | None | $141.25 | $213.80 | $323.59 |
Denver HMP Setting Facility Modifier None Typical Low $131.83 Median $194.98 Typical High $295.12 | Facility | None | $131.83 | $194.98 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $338.84 | Professional | None | $131.83 | $213.80 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $223.87 Typical High $416.87 | Facility | None | $199.53 | $223.87 | $416.87 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $199.53 Typical High $389.05 | Professional | None | $85.11 | $199.53 | $389.05 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,174.90 Typical High $2,951.21 | Facility | None | $489.78 | $1,174.90 | $2,951.21 |
United Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $371.54 | Professional | None | $138.04 | $223.87 | $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 $66.07 Median $81.28 Typical High $97.72 | Professional | 52 · Reduced service | $66.07 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $33.11 Typical High $38.90 | Professional | 53 · Discontinued | $26.30 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $123.03 Typical High $144.54 | Professional | 54 · Surgery only | $100.00 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $24.55 Typical High $28.84 | Professional | 55 · Aftercare only | $19.95 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $16.60 Typical High $19.50 | Professional | 56 · Pre-op care only | $13.18 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $114.82 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $93.33 | $114.82 | $134.90 |
Where Colorado sits
The same service costs 4.1 times more in Alaska 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
$245
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.