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 $1,479.11 Median $3,548.13 Typical High $10,715.19 | Facility | None | $1,479.11 | $3,548.13 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $3,235.94 | Professional | None | $660.69 | $660.69 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,737.80 | Professional | None | $831.76 | $1,174.90 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,344.23 Typical High $4,786.30 | Facility | None | $676.08 | $2,344.23 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,380.38 | Professional | None | $758.58 | $1,000.00 | $1,380.38 |
Denver HMP Setting Facility Modifier None Typical Low $660.69 Median $891.25 Typical High $1,258.93 | Facility | None | $660.69 | $891.25 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $1,318.26 | Professional | None | $630.96 | $891.25 | $1,318.26 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $1,318.26 | Facility | None | $630.96 | $1,258.93 | $1,318.26 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $1,230.27 | Professional | None | $436.52 | $630.96 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $10,232.93 | Facility | None | $1,479.11 | $3,548.13 | $10,232.93 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,621.81 | Professional | None | $776.25 | $1,023.29 | $1,621.81 |
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 $323.59 Median $323.59 Typical High $389.05 | Professional | 52 · Reduced service | $323.59 | $323.59 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $158.49 | Professional | 53 · Discontinued | $131.83 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $588.84 | Professional | 54 · Surgery only | $489.78 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $117.49 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $79.43 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $549.54 |
Where Colorado sits
The same service costs 6.9 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· 9th of 51
$1,413
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.