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 $190.55 Median $218.78 Typical High $489.78 | Professional | None | $190.55 | $218.78 | $489.78 |
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 $223.87 Median $316.23 Typical High $478.63 | Professional | None | $223.87 | $316.23 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $3,235.94 | Facility | None | $588.84 | $2,187.76 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $380.19 | Professional | None | $213.80 | $281.84 | $380.19 |
Denver HMP Setting Facility Modifier None Typical Low $190.55 Median $269.15 Typical High $426.58 | Facility | None | $190.55 | $269.15 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $398.11 | Professional | None | $181.97 | $275.42 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $416.87 Typical High $2,884.03 | Facility | None | $223.87 | $416.87 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $223.87 Typical High $436.52 | Professional | None | $120.23 | $223.87 | $436.52 |
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 $288.40 Typical High $446.68 | Professional | None | $223.87 | $288.40 | $446.68 |
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 $95.50 Median $109.65 Typical High $123.03 | Professional | 52 · Reduced service | $95.50 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $43.65 Typical High $48.98 | Professional | 53 · Discontinued | $38.02 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $165.96 Typical High $181.97 | Professional | 54 · Surgery only | $144.54 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.11 Typical High $36.31 | Professional | 55 · Aftercare only | $28.84 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.88 Typical High $24.55 | Professional | 56 · Pre-op care only | $19.05 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $154.88 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $134.90 | $154.88 | $169.82 |
Where Colorado sits
The same service costs 5.9 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· 17th of 51
$347
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.