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 $2,691.53 Median $6,025.60 Typical High $16,218.10 | Facility | None | $2,691.53 | $6,025.60 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $6,456.54 | Professional | None | $1,071.52 | $1,148.15 | $6,456.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $15,135.61 Median $19,498.45 Typical High $42,657.95 | Facility | None | $15,135.61 | $19,498.45 | $42,657.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,174.90 | $1,548.82 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $6,025.60 Median $6,606.93 Typical High $15,488.17 | Facility | None | $6,025.60 | $6,606.93 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,230.27 | $1,584.89 | $2,137.96 |
Denver HMP Setting Facility Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $1,698.24 | Facility | None | $1,148.15 | $1,445.44 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $13,489.63 | Professional | None | $912.01 | $1,348.96 | $13,489.63 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $1,778.28 Typical High $1,995.26 | Facility | None | $954.99 | $1,778.28 | $1,995.26 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $954.99 | Professional | None | $676.08 | $676.08 | $954.99 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $16,218.10 | Facility | None | $2,511.89 | $6,025.60 | $16,218.10 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,288.25 | $1,621.81 | $2,691.53 |
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 $537.03 Median $575.44 Typical High $602.56 | Professional | 52 · Reduced service | $537.03 | $575.44 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $229.09 Typical High $239.88 | Professional | 53 · Discontinued | $213.80 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $870.96 Typical High $912.01 | Professional | 54 · Surgery only | $794.33 | $870.96 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $173.78 Typical High $181.97 | Professional | 55 · Aftercare only | $158.49 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $114.82 Typical High $120.23 | Professional | 56 · Pre-op care only | $107.15 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $812.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $741.31 | $812.83 | $851.14 |
Where Colorado sits
The same service costs 8.9 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· 5th of 51
$3,090
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.