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 $1,995.26 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $6,025.60 | Professional | None | $912.01 | $977.24 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $2,089.30 | Professional | None | $977.24 | $1,412.54 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,630.78 Typical High $5,754.40 | Facility | None | $831.76 | $3,630.78 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,584.89 | Professional | None | $831.76 | $1,148.15 | $1,584.89 |
Denver HMP Setting Facility Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,905.46 | Facility | None | $891.25 | $1,023.29 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,621.81 | Professional | None | $776.25 | $1,071.52 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $776.25 Median $1,548.82 Typical High $5,011.87 | Facility | None | $776.25 | $1,548.82 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $1,513.56 | Professional | None | $537.03 | $776.25 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,819.70 | Professional | None | $870.96 | $1,122.02 | $1,819.70 |
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 $446.68 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $446.68 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $177.83 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $89.13 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $691.83 | $691.83 |
Where Colorado sits
The same service costs 7.4 times more in Oklahoma than in Texas. 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· 10th of 51
$1,698
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.