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 $2,454.71 Median $4,073.80 Typical High $10,964.78 | Facility | None | $2,454.71 | $4,073.80 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $5,495.41 | Professional | None | $478.63 | $489.78 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $11,481.54 Typical High $18,620.87 | Facility | None | $7,585.78 | $11,481.54 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $1,047.13 | Professional | None | $501.19 | $707.95 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $4,365.16 Typical High $6,760.83 | Facility | None | $1,778.28 | $4,365.16 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $851.14 | Professional | None | $457.09 | $630.96 | $851.14 |
Denver HMP Setting Facility Modifier None Typical Low $489.78 Median $575.44 Typical High $851.14 | Facility | None | $489.78 | $575.44 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $851.14 | Professional | None | $398.11 | $562.34 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $794.33 Typical High $5,011.87 | Facility | None | $398.11 | $794.33 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $776.25 | Professional | None | $281.84 | $398.11 | $776.25 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $977.24 | Professional | None | $489.78 | $616.60 | $977.24 |
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 $218.78 Median $245.47 Typical High $275.42 | Professional | 52 · Reduced service | $218.78 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $100.00 Typical High $109.65 | Professional | 53 · Discontinued | $89.13 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $371.54 Typical High $416.87 | Professional | 54 · Surgery only | $331.13 | $371.54 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $74.13 Typical High $83.18 | Professional | 55 · Aftercare only | $66.07 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $48.98 Typical High $54.95 | Professional | 56 · Pre-op care only | $44.67 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $346.74 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $309.03 | $346.74 | $389.05 |
Where Colorado sits
The same service costs 9.5 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· 14th of 51
$871
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.