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 $660.69 Median $3,235.94 Typical High $10,715.19 | Facility | None | $660.69 | $3,235.94 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $1,995.26 | Professional | None | $467.74 | $524.81 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $1,096.48 | Professional | None | $524.81 | $741.31 | $1,096.48 |
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 $478.63 Median $660.69 Typical High $891.25 | Professional | None | $478.63 | $660.69 | $891.25 |
Denver HMP Setting Facility Modifier None Typical Low $524.81 Median $616.60 Typical High $891.25 | Facility | None | $524.81 | $616.60 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $891.25 | Professional | None | $426.58 | $588.84 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $851.14 Typical High $2,884.03 | Facility | None | $426.58 | $851.14 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $831.76 | Professional | None | $295.12 | $426.58 | $831.76 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $1,047.13 | Professional | None | $524.81 | $660.69 | $1,047.13 |
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 $234.42 Median $263.03 Typical High $288.40 | Professional | 52 · Reduced service | $234.42 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $104.71 Typical High $117.49 | Professional | 53 · Discontinued | $93.33 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $389.05 Typical High $436.52 | Professional | 54 · Surgery only | $346.74 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $77.62 Typical High $87.10 | Professional | 55 · Aftercare only | $69.18 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $52.48 Typical High $57.54 | Professional | 56 · Pre-op care only | $46.77 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $363.08 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $323.59 | $363.08 | $407.38 |
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
$912
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.