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 $1,479.11 Median $3,715.35 Typical High $10,715.19 | Facility | None | $1,479.11 | $3,715.35 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $371.54 | Professional | None | $239.88 | $309.03 | $371.54 |
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 $223.87 Median $288.40 Typical High $489.78 | Professional | None | $223.87 | $288.40 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $446.68 Typical High $1,659.59 | Facility | None | $309.03 | $446.68 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $501.19 | Professional | None | $223.87 | $302.00 | $501.19 |
Denver HMP Setting Facility Modifier None Typical Low $239.88 Median $371.54 Typical High $524.81 | Facility | None | $239.88 | $371.54 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $501.19 | Professional | None | $223.87 | $331.13 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $380.19 Typical High $691.83 | Facility | None | $331.13 | $380.19 | $691.83 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $331.13 | Professional | None | $131.83 | $208.93 | $331.13 |
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 $223.87 Median $338.84 Typical High $549.54 | Professional | None | $223.87 | $338.84 | $549.54 |
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 $120.23 Median $134.90 Typical High $186.21 | Professional | 52 · Reduced service | $120.23 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $53.70 Typical High $74.13 | Professional | 53 · Discontinued | $47.86 | $53.70 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $204.17 Typical High $275.42 | Professional | 54 · Surgery only | $177.83 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $40.74 Typical High $56.23 | Professional | 55 · Aftercare only | $35.48 | $40.74 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $26.92 Typical High $37.15 | Professional | 56 · Pre-op care only | $23.99 | $26.92 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $190.55 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $165.96 | $190.55 | $257.04 |
Where Colorado sits
The same service costs 4.3 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· 17th of 51
$380
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.