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 $851.14 Median $851.14 Typical High $5,495.41 | Professional | None | $851.14 | $851.14 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $7,244.36 Typical High $13,182.57 | Facility | None | $4,786.30 | $7,244.36 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,995.26 | Professional | None | $954.99 | $1,348.96 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,621.81 | Professional | None | $870.96 | $1,202.26 | $1,621.81 |
Denver HMP Setting Facility Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,862.09 | Facility | None | $851.14 | $1,096.48 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,584.89 | Professional | None | $758.58 | $1,047.13 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $1,584.89 | Facility | None | $758.58 | $1,513.56 | $1,584.89 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $1,479.11 | Professional | None | $524.81 | $758.58 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $3,548.13 Typical High $10,000.00 | Facility | None | $1,445.44 | $3,548.13 | $10,000.00 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,905.46 | Professional | None | $954.99 | $1,202.26 | $1,905.46 |
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 $416.87 Median $416.87 Typical High $524.81 | Professional | 52 · Reduced service | $416.87 | $416.87 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $213.80 | Professional | 53 · Discontinued | $169.82 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $794.33 | Professional | 54 · Surgery only | $630.96 | $630.96 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $158.49 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $104.71 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $741.31 |
Where Colorado sits
The same service costs 6.2 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· 11th of 51
$1,622
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.