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 $562.34 Median $676.08 Typical High $1,122.02 | Professional | None | $562.34 | $676.08 | $1,122.02 |
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 $616.60 Median $812.83 Typical High $1,412.54 | Professional | None | $616.60 | $812.83 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,621.81 Typical High $3,311.31 | Facility | None | $831.76 | $1,621.81 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $954.99 | Professional | None | $478.63 | $645.65 | $954.99 |
Denver HMP Setting Facility Modifier None Typical Low $575.44 Median $707.95 Typical High $1,258.93 | Facility | None | $575.44 | $707.95 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $1,000.00 | Professional | None | $512.86 | $676.08 | $1,000.00 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $1,023.29 Typical High $1,819.70 | Facility | None | $512.86 | $1,023.29 | $1,819.70 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $741.31 | Professional | None | $363.08 | $562.34 | $741.31 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $1,148.15 | Professional | None | $501.19 | $691.83 | $1,148.15 |
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 $281.84 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $281.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $112.20 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $426.58 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $85.11 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $56.23 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $398.11 | $478.63 | $478.63 |
Where Colorado sits
The same service costs 8.5 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· 8th of 51
$1,122
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.