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 $2,570.40 Median $5,495.41 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $5,495.41 | Professional | None | $602.56 | $602.56 | $5,495.41 |
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 $676.08 Median $954.99 Typical High $1,412.54 | Professional | None | $676.08 | $954.99 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,818.38 Typical High $4,365.16 | Facility | None | $758.58 | $2,818.38 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,148.15 | Professional | None | $645.65 | $851.14 | $1,148.15 |
Denver HMP Setting Facility Modifier None Typical Low $602.56 Median $794.33 Typical High $1,348.96 | Facility | None | $602.56 | $794.33 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,122.02 | Professional | None | $537.03 | $758.58 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $1,071.52 Typical High $3,801.89 | Facility | None | $537.03 | $1,071.52 | $3,801.89 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $1,047.13 | Professional | None | $371.54 | $537.03 | $1,047.13 |
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 $676.08 Median $851.14 Typical High $1,348.96 | Professional | None | $676.08 | $851.14 | $1,348.96 |
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 $302.00 Median $302.00 Typical High $371.54 | Professional | 52 · Reduced service | $302.00 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $147.91 | Professional | 53 · Discontinued | $120.23 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $562.34 | Professional | 54 · Surgery only | $446.68 | $446.68 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $112.20 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $74.13 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $524.81 |
Where Colorado sits
The same service costs 9.8 times more in Oklahoma than in Utah. 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· 12th of 51
$1,175
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.