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 $151.36 Median $229.09 Typical High $426.58 | Professional | None | $151.36 | $229.09 | $426.58 |
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 $173.78 Median $239.88 Typical High $354.81 | Professional | None | $173.78 | $239.88 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $223.87 Typical High $407.38 | Facility | None | $52.48 | $223.87 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $407.38 | Professional | None | $165.96 | $251.19 | $407.38 |
Denver HMP Setting Facility Modifier None Typical Low $151.36 Median $239.88 Typical High $346.74 | Facility | None | $151.36 | $239.88 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $416.87 | Professional | None | $151.36 | $257.04 | $416.87 |
Select Health Setting Facility Modifier None Typical Low $245.47 Median $275.42 Typical High $512.86 | Facility | None | $245.47 | $275.42 | $512.86 |
Select Health Setting Professional Modifier None Typical Low $95.50 Median $245.47 Typical High $478.63 | Professional | None | $95.50 | $245.47 | $478.63 |
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 $165.96 Median $269.15 Typical High $457.09 | Professional | None | $165.96 | $269.15 | $457.09 |
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 $75.86 Median $102.33 Typical High $120.23 | Professional | 52 · Reduced service | $75.86 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $40.74 Typical High $47.86 | Professional | 53 · Discontinued | $30.20 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $154.88 Typical High $181.97 | Professional | 54 · Surgery only | $114.82 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $30.90 Typical High $36.31 | Professional | 55 · Aftercare only | $22.91 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $20.42 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.14 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $144.54 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $107.15 | $144.54 | $169.82 |
Where Colorado sits
The same service costs 4.6 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· 14th of 51
$295
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.