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 $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $2,570.40 | Professional | None | $707.95 | $707.95 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $11,481.54 Median $16,982.44 Typical High $38,904.51 | Facility | None | $11,481.54 | $16,982.44 | $38,904.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,862.09 | Professional | None | $891.25 | $1,258.93 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,981.07 Typical High $6,165.95 | Facility | None | $758.58 | $3,981.07 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,479.11 | Professional | None | $812.83 | $1,071.52 | $1,479.11 |
Denver HMP Setting Facility Modifier None Typical Low $707.95 Median $977.24 Typical High $1,412.54 | Facility | None | $707.95 | $977.24 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $1,445.44 | Professional | None | $691.83 | $977.24 | $1,445.44 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $1,380.38 Typical High $5,370.32 | Facility | None | $691.83 | $1,380.38 | $5,370.32 |
Select Health Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,348.96 | Professional | None | $489.78 | $691.83 | $1,348.96 |
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 $870.96 Median $1,096.48 Typical High $1,737.80 | Professional | None | $870.96 | $1,096.48 | $1,737.80 |
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 $354.81 Median $354.81 Typical High $426.58 | Professional | 52 · Reduced service | $354.81 | $354.81 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | 53 · Discontinued | $141.25 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $630.96 | Professional | 54 · Surgery only | $537.03 | $537.03 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $85.11 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $588.84 |
Where Colorado sits
The same service costs 6.8 times more in Oklahoma than in Texas. 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
$1,514
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.