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 $3,715.35 Typical High $10,715.19 | Facility | None | $1,479.11 | $3,715.35 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $3,235.94 | Professional | None | $954.99 | $1,071.52 | $3,235.94 |
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 $1,096.48 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,513.56 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,897.79 Typical High $9,549.93 | Facility | None | $691.83 | $4,897.79 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,380.38 | $1,819.70 |
Denver HMP Setting Facility Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,819.70 | Facility | None | $1,071.52 | $1,348.96 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,778.28 | Professional | None | $851.14 | $1,202.26 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,317.64 | Facility | None | $851.14 | $1,698.24 | $8,317.64 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,659.59 | Professional | None | $602.56 | $851.14 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,412.54 | $2,187.76 |
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 $478.63 Median $537.03 Typical High $602.56 | Professional | 52 · Reduced service | $478.63 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $213.80 Typical High $239.88 | Professional | 53 · Discontinued | $190.55 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $812.83 Typical High $912.01 | Professional | 54 · Surgery only | $724.44 | $812.83 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $162.18 Typical High $181.97 | Professional | 55 · Aftercare only | $144.54 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $107.15 Typical High $120.23 | Professional | 56 · Pre-op care only | $95.50 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $758.58 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $676.08 | $758.58 | $851.14 |
Where Colorado sits
The same service costs 6.3 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
$1,820
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.