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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $3,162.28 | Professional | None | $724.44 | $812.83 | $3,162.28 |
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 $831.76 Median $1,148.15 Typical High $1,737.80 | Professional | None | $831.76 | $1,148.15 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,311.31 Typical High $5,128.61 | Facility | None | $691.83 | $3,311.31 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,380.38 | Professional | None | $776.25 | $1,047.13 | $1,380.38 |
Denver HMP Setting Facility Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,380.38 | Facility | None | $812.83 | $1,000.00 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,380.38 | Professional | None | $660.69 | $912.01 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $1,318.26 Typical High $4,570.88 | Facility | None | $660.69 | $1,318.26 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $1,288.25 | Professional | None | $457.09 | $660.69 | $1,288.25 |
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 $812.83 Median $1,047.13 Typical High $1,659.59 | Professional | None | $812.83 | $1,047.13 | $1,659.59 |
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 $363.08 Median $407.38 Typical High $457.09 | Professional | 52 · Reduced service | $363.08 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $181.97 | Professional | 53 · Discontinued | $147.91 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $691.83 | Professional | 54 · Surgery only | $549.54 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $138.04 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $81.28 Typical High $91.20 | Professional | 56 · Pre-op care only | $72.44 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $645.65 |
Where Colorado sits
The same service costs 8.7 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
$1,413
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.