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 $1,071.52 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,071.52 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $3,235.94 | Professional | None | $691.83 | $691.83 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $11,481.54 Typical High $18,620.87 | Facility | None | $7,585.78 | $11,481.54 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,905.46 | Professional | None | $912.01 | $1,288.25 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,715.35 Typical High $5,754.40 | Facility | None | $758.58 | $3,715.35 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,548.82 | Professional | None | $794.33 | $1,096.48 | $1,548.82 |
Denver HMP Setting Facility Modifier None Typical Low $691.83 Median $977.24 Typical High $1,122.02 | Facility | None | $691.83 | $977.24 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,479.11 | Professional | None | $707.95 | $1,000.00 | $1,479.11 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $1,412.54 Typical High $5,011.87 | Facility | None | $707.95 | $1,412.54 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $1,380.38 | Professional | None | $489.78 | $707.95 | $1,380.38 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,778.28 | Professional | None | $870.96 | $1,122.02 | $1,778.28 |
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 $346.74 Median $346.74 Typical High $436.52 | Professional | 52 · Reduced service | $346.74 | $346.74 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $645.65 | Professional | 54 · Surgery only | $524.81 | $524.81 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $131.83 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $602.56 |
Where Colorado sits
The same service costs 10.5 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
$1,585
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.