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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $316.23 Typical High $2,570.40 | Professional | None | $309.03 | $316.23 | $2,570.40 |
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 $398.11 Median $562.34 Typical High $831.76 | Professional | None | $398.11 | $562.34 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,454.71 Typical High $3,311.31 | Facility | None | $691.83 | $2,454.71 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $645.65 | Professional | None | $331.13 | $446.68 | $645.65 |
Denver HMP Setting Facility Modifier None Typical Low $309.03 Median $398.11 Typical High $602.56 | Facility | None | $309.03 | $398.11 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $630.96 | Professional | None | $302.00 | $426.58 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $602.56 Typical High $2,884.03 | Facility | None | $302.00 | $602.56 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $588.84 | Professional | None | $213.80 | $302.00 | $588.84 |
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 $354.81 Median $457.09 Typical High $741.31 | Professional | None | $354.81 | $457.09 | $741.31 |
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 $154.88 Median $154.88 Typical High $186.21 | Professional | 52 · Reduced service | $154.88 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $74.13 | Professional | 53 · Discontinued | $63.10 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $275.42 | Professional | 54 · Surgery only | $234.42 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $54.95 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $37.15 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $218.78 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $218.78 | $218.78 | $257.04 |
Where Colorado sits
The same service costs 11.2 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
$676
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.