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 $2,570.40 Median $5,495.41 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $6,025.60 | Professional | None | $630.96 | $630.96 | $6,025.60 |
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 $645.65 Median $912.01 Typical High $1,348.96 | Professional | None | $645.65 | $912.01 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,454.71 Typical High $3,801.89 | Facility | None | $933.25 | $2,454.71 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,071.52 | Professional | None | $562.34 | $794.33 | $1,071.52 |
Denver HMP Setting Facility Modifier None Typical Low $575.44 Median $676.08 Typical High $1,096.48 | Facility | None | $575.44 | $676.08 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,122.02 | Professional | None | $537.03 | $758.58 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $1,071.52 Typical High $2,884.03 | Facility | None | $537.03 | $1,071.52 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $1,047.13 | Professional | None | $380.19 | $537.03 | $1,047.13 |
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 $575.44 Median $794.33 Typical High $1,288.25 | Professional | None | $575.44 | $794.33 | $1,288.25 |
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 $281.84 Median $316.23 Typical High $354.81 | Professional | 52 · Reduced service | $281.84 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $125.89 Typical High $141.25 | Professional | 53 · Discontinued | $114.82 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $478.63 Typical High $524.81 | Professional | 54 · Surgery only | $426.58 | $478.63 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $95.50 Typical High $104.71 | Professional | 55 · Aftercare only | $85.11 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $63.10 Typical High $70.79 | Professional | 56 · Pre-op care only | $57.54 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $446.68 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $398.11 | $446.68 | $489.78 |
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
$1,122
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.