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 $1,479.11 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,479.11 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $3,162.28 | Professional | None | $758.58 | $851.14 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,778.28 | Professional | None | $870.96 | $1,202.26 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,398.83 Typical High $3,235.94 | Facility | None | $691.83 | $2,398.83 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,445.44 | Professional | None | $812.83 | $1,096.48 | $1,445.44 |
Denver HMP Setting Facility Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,445.44 | Facility | None | $851.14 | $1,071.52 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,445.44 | Professional | None | $676.08 | $954.99 | $1,445.44 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $1,348.96 Typical High $2,884.03 | Facility | None | $676.08 | $1,348.96 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $1,318.26 | Professional | None | $478.63 | $676.08 | $1,318.26 |
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 $1,737.80 | Professional | None | $870.96 | $1,122.02 | $1,737.80 |
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 $380.19 Median $426.58 Typical High $478.63 | Professional | 52 · Reduced service | $380.19 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $169.82 Typical High $190.55 | Professional | 53 · Discontinued | $151.36 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $645.65 Typical High $724.44 | Professional | 54 · Surgery only | $575.44 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $128.82 Typical High $144.54 | Professional | 55 · Aftercare only | $114.82 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $85.11 Typical High $95.50 | Professional | 56 · Pre-op care only | $75.86 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $602.56 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $537.03 | $602.56 | $676.08 |
Where Colorado sits
The same service costs 7.9 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· 12th of 51
$1,479
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.