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 $194.98 Median $239.88 Typical High $446.68 | Professional | None | $194.98 | $239.88 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $512.86 | Professional | None | $229.09 | $338.84 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,445.44 Typical High $2,187.76 | Facility | None | $588.84 | $1,445.44 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $407.38 | Professional | None | $218.78 | $288.40 | $407.38 |
Denver HMP Setting Facility Modifier None Typical Low $194.98 Median $275.42 Typical High $426.58 | Facility | None | $194.98 | $275.42 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $416.87 | Professional | None | $186.21 | $281.84 | $416.87 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $436.52 Typical High $1,659.59 | Facility | None | $234.42 | $436.52 | $1,659.59 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $234.42 Typical High $457.09 | Professional | None | $120.23 | $234.42 | $457.09 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $467.74 | Professional | None | $223.87 | $309.03 | $467.74 |
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 $97.72 Median $117.49 Typical High $125.89 | Professional | 52 · Reduced service | $97.72 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $47.86 Typical High $50.12 | Professional | 53 · Discontinued | $38.90 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $177.83 Typical High $186.21 | Professional | 54 · Surgery only | $144.54 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $35.48 Typical High $37.15 | Professional | 55 · Aftercare only | $29.51 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $23.99 Typical High $25.12 | Professional | 56 · Pre-op care only | $19.50 | $23.99 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $165.96 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $134.90 | $165.96 | $173.78 |
Where Colorado sits
The same service costs 5.6 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· 14th of 51
$372
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.