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 $1,513.56 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,513.56 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $3,630.78 | Professional | None | $426.58 | $426.58 | $3,630.78 |
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 $537.03 Median $758.58 Typical High $1,122.02 | Professional | None | $537.03 | $758.58 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $3,311.31 | Facility | None | $588.84 | $2,187.76 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $891.25 | Professional | None | $457.09 | $630.96 | $891.25 |
Denver HMP Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $812.83 | Facility | None | $426.58 | $549.54 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $870.96 | Professional | None | $407.38 | $588.84 | $870.96 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $831.76 Typical High $2,884.03 | Facility | None | $407.38 | $831.76 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $794.33 | Professional | None | $288.40 | $407.38 | $794.33 |
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 $489.78 Median $645.65 Typical High $1,023.29 | Professional | None | $489.78 | $645.65 | $1,023.29 |
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 $213.80 Median $213.80 Typical High $251.19 | Professional | 52 · Reduced service | $213.80 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $102.33 | Professional | 53 · Discontinued | $85.11 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $380.19 | Professional | 54 · Surgery only | $316.23 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $50.12 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $354.81 |
Where Colorado sits
The same service costs 8.9 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· 11th of 51
$933
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.