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 $1,258.93 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $398.11 | Professional | None | $144.54 | $218.78 | $398.11 |
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 $177.83 Median $288.40 Typical High $501.19 | Professional | None | $177.83 | $288.40 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $363.08 Typical High $2,691.53 | Facility | None | $208.93 | $363.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $371.54 | Professional | None | $154.88 | $239.88 | $371.54 |
Denver HMP Setting Facility Modifier None Typical Low $144.54 Median $223.87 Typical High $331.13 | Facility | None | $144.54 | $223.87 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $239.88 Typical High $389.05 | Professional | None | $141.25 | $239.88 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $257.04 Typical High $478.63 | Facility | None | $223.87 | $257.04 | $478.63 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $223.87 Typical High $436.52 | Professional | None | $91.20 | $223.87 | $436.52 |
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 $158.49 Median $257.04 Typical High $426.58 | Professional | None | $158.49 | $257.04 | $426.58 |
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 $72.44 Median $95.50 Typical High $112.20 | Professional | 52 · Reduced service | $72.44 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $38.02 Typical High $45.71 | Professional | 53 · Discontinued | $28.84 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $141.25 Typical High $169.82 | Professional | 54 · Surgery only | $107.15 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $28.18 Typical High $33.88 | Professional | 55 · Aftercare only | $21.38 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $19.05 Typical High $22.39 | Professional | 56 · Pre-op care only | $14.45 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $131.83 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $100.00 | $131.83 | $158.49 |
Where Colorado sits
The same service costs 3.5 times more in Wisconsin 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· 13th 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.