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 $741.31 Median $812.83 Typical High $3,235.94 | Professional | None | $741.31 | $812.83 | $3,235.94 |
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 $831.76 Median $1,148.15 Typical High $1,698.24 | Professional | None | $831.76 | $1,148.15 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,454.71 Typical High $3,311.31 | Facility | None | $758.58 | $2,454.71 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,412.54 | Professional | None | $776.25 | $1,023.29 | $1,412.54 |
Denver HMP Setting Facility Modifier None Typical Low $812.83 Median $977.24 Typical High $1,380.38 | Facility | None | $812.83 | $977.24 | $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 $2,884.03 | Facility | None | $660.69 | $1,318.26 | $2,884.03 |
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 $1,479.11 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 $812.83 Median $1,047.13 Typical High $1,621.81 | Professional | None | $812.83 | $1,047.13 | $1,621.81 |
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 $144.54 Median $162.18 Typical High $181.97 | Professional | 53 · Discontinued | $144.54 | $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 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· 10th 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.