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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $478.63 | Professional | None | $295.12 | $346.74 | $478.63 |
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 $281.84 Median $363.08 Typical High $616.60 | Professional | None | $281.84 | $363.08 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $346.74 Typical High $1,659.59 | Facility | None | $223.87 | $346.74 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $501.19 Typical High $707.95 | Professional | None | $288.40 | $501.19 | $707.95 |
Denver HMP Setting Facility Modifier None Typical Low $302.00 Median $501.19 Typical High $776.25 | Facility | None | $302.00 | $501.19 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $363.08 Typical High $467.74 | Professional | None | $245.47 | $363.08 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $269.15 Median $309.03 Typical High $645.65 | Facility | None | $269.15 | $309.03 | $645.65 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $263.03 Typical High $316.23 | Professional | None | $154.88 | $263.03 | $316.23 |
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 $302.00 Median $501.19 Typical High $758.58 | Professional | None | $302.00 | $501.19 | $758.58 |
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 $147.91 Median $151.36 Typical High $173.78 | Professional | 52 · Reduced service | $147.91 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $60.26 Typical High $69.18 | Professional | 53 · Discontinued | $58.88 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | 54 · Surgery only | $223.87 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $30.20 Typical High $34.67 | Professional | 56 · Pre-op care only | $29.51 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $208.93 | $208.93 | $245.47 |
Where Colorado sits
The same service costs 5.1 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· 19th of 51
$513
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.