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 $977.24 Median $1,096.48 Typical High $3,162.28 | Professional | None | $977.24 | $1,096.48 | $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 $1,122.02 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,548.82 | $2,290.87 |
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 $1,047.13 Median $1,412.54 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,412.54 | $1,862.09 |
Denver HMP Setting Facility Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,862.09 | Facility | None | $1,096.48 | $1,318.26 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $1,819.70 | Professional | None | $870.96 | $1,230.27 | $1,819.70 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $1,737.80 Typical High $2,884.03 | Facility | None | $870.96 | $1,737.80 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,698.24 | Professional | None | $616.60 | $870.96 | $1,698.24 |
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 $1,122.02 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,445.44 | $2,238.72 |
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 $489.78 Median $549.54 Typical High $616.60 | Professional | 52 · Reduced service | $489.78 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $245.47 | Professional | 53 · Discontinued | $199.53 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $831.76 Typical High $933.25 | Professional | 54 · Surgery only | $741.31 | $831.76 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $165.96 Typical High $186.21 | Professional | 55 · Aftercare only | $147.91 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $109.65 Typical High $123.03 | Professional | 56 · Pre-op care only | $97.72 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $776.25 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $691.83 | $776.25 | $870.96 |
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· 10th of 51
$1,862
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.