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 $154.88 Median $3,235.94 Typical High $8,709.64 | Facility | None | $154.88 | $3,235.94 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $194.98 | Professional | None | $102.33 | $131.83 | $194.98 |
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 $109.65 Median $144.54 Typical High $245.47 | Professional | None | $109.65 | $144.54 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $177.83 Typical High $1,659.59 | Facility | None | $104.71 | $177.83 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $194.98 | Professional | None | $97.72 | $131.83 | $194.98 |
Denver HMP Setting Facility Modifier None Typical Low $120.23 Median $154.88 Typical High $223.87 | Facility | None | $120.23 | $154.88 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $208.93 | Professional | None | $104.71 | $147.91 | $208.93 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $134.90 Typical High $281.84 | Facility | None | $125.89 | $134.90 | $281.84 |
Select Health Setting Professional Modifier None Typical Low $61.66 Median $107.15 Typical High $134.90 | Professional | None | $61.66 | $107.15 | $134.90 |
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 $104.71 Median $144.54 Typical High $234.42 | Professional | None | $104.71 | $144.54 | $234.42 |
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 $56.23 Median $60.26 Typical High $77.62 | Professional | 52 · Reduced service | $56.23 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $24.55 Typical High $30.90 | Professional | 53 · Discontinued | $22.39 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $91.20 Typical High $114.82 | Professional | 54 · Surgery only | $83.18 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $18.20 Typical High $23.44 | Professional | 55 · Aftercare only | $16.60 | $18.20 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.02 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.22 | $12.02 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $85.11 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $77.62 | $85.11 | $107.15 |
Where Colorado sits
The same service costs 4.0 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
$162
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.