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 $1,995.26 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $5,495.41 | Professional | None | $588.84 | $588.84 | $5,495.41 |
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 $707.95 Median $1,000.00 Typical High $1,479.11 | Professional | None | $707.95 | $1,000.00 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,630.78 Typical High $5,754.40 | Facility | None | $831.76 | $3,630.78 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,148.15 | Professional | None | $630.96 | $851.14 | $1,148.15 |
Denver HMP Setting Facility Modifier None Typical Low $588.84 Median $776.25 Typical High $1,071.52 | Facility | None | $588.84 | $776.25 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,122.02 | Professional | None | $537.03 | $758.58 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $1,071.52 Typical High $5,011.87 | Facility | None | $537.03 | $1,071.52 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $1,047.13 | Professional | None | $371.54 | $537.03 | $1,047.13 |
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 $645.65 Median $851.14 Typical High $1,348.96 | Professional | None | $645.65 | $851.14 | $1,348.96 |
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 $295.12 Median $295.12 Typical High $346.74 | Professional | 52 · Reduced service | $295.12 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $138.04 | Professional | 53 · Discontinued | $117.49 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $524.81 | Professional | 54 · Surgery only | $446.68 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $104.71 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $489.78 |
Where Colorado sits
The same service costs 8.1 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
$1,202
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.