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 $3,090.30 Median $5,495.41 Typical High $18,620.87 | Facility | None | $3,090.30 | $5,495.41 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $5,495.41 | Professional | None | $616.60 | $676.08 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $11,481.54 Median $16,982.44 Typical High $38,904.51 | Facility | None | $11,481.54 | $16,982.44 | $38,904.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,584.89 | Professional | None | $758.58 | $1,071.52 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $10,232.93 Typical High $19,498.45 | Facility | None | $758.58 | $10,232.93 | $19,498.45 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,230.27 | Professional | None | $676.08 | $912.01 | $1,230.27 |
Denver HMP Setting Facility Modifier None Typical Low $676.08 Median $724.44 Typical High $1,122.02 | Facility | None | $676.08 | $724.44 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,202.26 | Professional | None | $575.44 | $812.83 | $1,202.26 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $17,378.01 | Facility | None | $575.44 | $1,148.15 | $17,378.01 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $1,122.02 | Professional | None | $398.11 | $575.44 | $1,122.02 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,445.44 | Professional | None | $724.44 | $933.25 | $1,445.44 |
5 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 $302.00 Median $331.13 Typical High $346.74 | Professional | 52 · Reduced service | $302.00 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $134.90 Typical High $138.04 | Professional | 53 · Discontinued | $120.23 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $501.19 Typical High $524.81 | Professional | 54 · Surgery only | $457.09 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $104.71 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $67.61 Typical High $69.18 | Professional | 56 · Pre-op care only | $60.26 | $67.61 | $69.18 |
Where Colorado sits
The same service costs 11.7 times more in Oklahoma 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· 11th of 51
$1,318
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.