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 $316.23 Median $316.23 Typical High $5,495.41 | Professional | None | $316.23 | $316.23 | $5,495.41 |
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 $575.44 Typical High $831.76 | Professional | None | $398.11 | $575.44 | $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 $338.84 Median $467.74 Typical High $645.65 | Professional | None | $338.84 | $467.74 | $645.65 |
Denver HMP Setting Facility Modifier None Typical Low $316.23 Median $416.87 Typical High $602.56 | Facility | None | $316.23 | $416.87 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $645.65 | Professional | None | $309.03 | $436.52 | $645.65 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $616.60 Typical High $2,884.03 | Facility | None | $309.03 | $616.60 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $602.56 | Professional | None | $213.80 | $309.03 | $602.56 |
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 $363.08 Median $467.74 Typical High $758.58 | Professional | None | $363.08 | $467.74 | $758.58 |
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 $158.49 Median $158.49 Typical High $186.21 | Professional | 52 · Reduced service | $158.49 | $158.49 | $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 $239.88 Median $239.88 Typical High $281.84 | Professional | 54 · Surgery only | $239.88 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $56.23 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $37.15 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $223.87 | $223.87 | $263.03 |
Where Colorado sits
The same service costs 11.7 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
$708
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.