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 $1,148.15 Median $3,388.44 Typical High $8,709.64 | Facility | None | $1,148.15 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $5,495.41 | Professional | None | $831.76 | $870.96 | $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 $1,000.00 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,412.54 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,659.59 Typical High $2,818.38 | Facility | None | $436.52 | $1,659.59 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,659.59 | Professional | None | $870.96 | $1,202.26 | $1,659.59 |
Denver HMP Setting Facility Modifier None Typical Low $776.25 Median $1,122.02 Typical High $1,479.11 | Facility | None | $776.25 | $1,122.02 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,621.81 | Professional | None | $758.58 | $1,071.52 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $1,548.82 Typical High $2,454.71 | Facility | None | $758.58 | $1,548.82 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,479.11 | Professional | None | $537.03 | $758.58 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $5,754.40 Typical High $13,489.63 | Facility | None | $1,949.84 | $5,754.40 | $13,489.63 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,905.46 | Professional | None | $954.99 | $1,202.26 | $1,905.46 |
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 $416.87 Median $436.52 Typical High $478.63 | Professional | 52 · Reduced service | $416.87 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $173.78 Typical High $190.55 | Professional | 53 · Discontinued | $169.82 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $660.69 Typical High $707.95 | Professional | 54 · Surgery only | $630.96 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $131.83 Typical High $141.25 | Professional | 55 · Aftercare only | $125.89 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $83.18 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $616.60 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $588.84 | $616.60 | $660.69 |
Where Colorado sits
The same service costs 6.9 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· 10th of 51
$1,660
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.