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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,659.59 | Professional | None | $831.76 | $1,000.00 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $2,137.96 | Professional | None | $933.25 | $1,230.27 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,454.71 Typical High $3,311.31 | Facility | None | $691.83 | $2,454.71 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,348.96 | Professional | None | $645.65 | $912.01 | $1,348.96 |
Denver HMP Setting Facility Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,905.46 | Facility | None | $794.33 | $1,000.00 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,513.56 | Professional | None | $794.33 | $1,023.29 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $794.33 Median $1,584.89 Typical High $2,884.03 | Facility | None | $794.33 | $1,584.89 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $1,148.15 | Professional | None | $549.54 | $831.76 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,698.24 | Professional | None | $676.08 | $933.25 | $1,698.24 |
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 $398.11 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $398.11 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $158.49 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $120.23 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $79.43 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $707.95 | $707.95 |
Where Colorado sits
The same service costs 8.3 times more in Wyoming 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· 13th of 51
$1,549
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.