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 $398.11 Median $416.87 Typical High $3,162.28 | Professional | None | $398.11 | $416.87 | $3,162.28 |
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 $501.19 Median $724.44 Typical High $1,047.13 | Professional | None | $501.19 | $724.44 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,454.71 Typical High $3,311.31 | Facility | None | $758.58 | $2,454.71 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $831.76 | Professional | None | $436.52 | $588.84 | $831.76 |
Denver HMP Setting Facility Modifier None Typical Low $398.11 Median $512.86 Typical High $758.58 | Facility | None | $398.11 | $512.86 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $851.14 | Professional | None | $380.19 | $549.54 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $2,884.03 | Facility | None | $380.19 | $776.25 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $741.31 | Professional | None | $269.15 | $380.19 | $741.31 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,762.47 | Facility | None | $1,288.25 | $2,511.89 | $7,762.47 |
United Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $954.99 | Professional | None | $457.09 | $602.56 | $954.99 |
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 $199.53 Median $199.53 Typical High $234.42 | Professional | 52 · Reduced service | $199.53 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $95.50 | Professional | 53 · Discontinued | $79.43 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $354.81 | Professional | 54 · Surgery only | $295.12 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $70.79 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $47.86 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $331.13 |
Where Colorado sits
The same service costs 10.2 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· 11th 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.