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 $1,258.93 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $363.08 | Professional | None | $138.04 | $208.93 | $363.08 |
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 $169.82 Median $275.42 Typical High $489.78 | Professional | None | $169.82 | $275.42 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $363.08 Typical High $2,691.53 | Facility | None | $208.93 | $363.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $363.08 | Professional | None | $147.91 | $229.09 | $363.08 |
Denver HMP Setting Facility Modifier None Typical Low $138.04 Median $218.78 Typical High $316.23 | Facility | None | $138.04 | $218.78 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $380.19 | Professional | None | $138.04 | $229.09 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $218.78 Median $257.04 Typical High $457.09 | Facility | None | $218.78 | $257.04 | $457.09 |
Select Health Setting Professional Modifier None Typical Low $87.10 Median $218.78 Typical High $426.58 | Professional | None | $87.10 | $218.78 | $426.58 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $416.87 | Professional | None | $147.91 | $245.47 | $416.87 |
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 $67.61 Median $93.33 Typical High $109.65 | Professional | 52 · Reduced service | $67.61 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $37.15 Typical High $43.65 | Professional | 53 · Discontinued | $27.54 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $138.04 Typical High $165.96 | Professional | 54 · Surgery only | $102.33 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $28.18 Typical High $33.11 | Professional | 55 · Aftercare only | $20.42 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $18.62 Typical High $21.88 | Professional | 56 · Pre-op care only | $13.80 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $128.82 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $95.50 | $128.82 | $154.88 |
Where Colorado sits
The same service costs 3.9 times more in Oklahoma than in Kentucky. 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· 10th of 51
$302
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.