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 $1,995.26 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $5,495.41 | Professional | None | $501.19 | $562.34 | $5,495.41 |
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 $575.44 Median $794.33 Typical High $1,174.90 | Professional | None | $575.44 | $794.33 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,454.71 Typical High $3,311.31 | Facility | None | $831.76 | $2,454.71 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $954.99 | Professional | None | $524.81 | $707.95 | $954.99 |
Denver HMP Setting Facility Modifier None Typical Low $562.34 Median $676.08 Typical High $954.99 | Facility | None | $562.34 | $676.08 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $954.99 | Professional | None | $457.09 | $645.65 | $954.99 |
Select Health Setting Facility Modifier None Typical Low $457.09 Median $912.01 Typical High $2,884.03 | Facility | None | $457.09 | $912.01 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $891.25 | Professional | None | $316.23 | $457.09 | $891.25 |
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 $562.34 Median $724.44 Typical High $1,122.02 | Professional | None | $562.34 | $724.44 | $1,122.02 |
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 $251.19 Median $281.84 Typical High $316.23 | Professional | 52 · Reduced service | $251.19 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $112.20 Typical High $125.89 | Professional | 53 · Discontinued | $100.00 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $380.19 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $85.11 Typical High $95.50 | Professional | 55 · Aftercare only | $75.86 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $56.23 Typical High $63.10 | Professional | 56 · Pre-op care only | $50.12 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $354.81 | $398.11 | $436.52 |
Where Colorado sits
The same service costs 10.0 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
$977
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.