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 $645.65 Median $758.58 Typical High $1,258.93 | Professional | None | $645.65 | $758.58 | $1,258.93 |
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 $691.83 Median $912.01 Typical High $1,548.82 | Professional | None | $691.83 | $912.01 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,454.71 Typical High $3,311.31 | Facility | None | $831.76 | $2,454.71 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $1,071.52 | Professional | None | $575.44 | $758.58 | $1,071.52 |
Denver HMP Setting Facility Modifier None Typical Low $676.08 Median $812.83 Typical High $1,412.54 | Facility | None | $676.08 | $812.83 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,122.02 | Professional | None | $562.34 | $741.31 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $562.34 Median $1,148.15 Typical High $2,884.03 | Facility | None | $562.34 | $1,148.15 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $630.96 Typical High $831.76 | Professional | None | $398.11 | $630.96 | $831.76 |
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 $575.44 Median $812.83 Typical High $1,288.25 | Professional | None | $575.44 | $812.83 | $1,288.25 |
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 $323.59 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $323.59 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $478.63 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $95.50 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $446.68 | $537.03 | $537.03 |
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· 9th of 51
$1,259
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.