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 $5,495.41 Typical High $10,964.78 | Facility | None | $1,995.26 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $7,244.36 Median $10,964.78 Typical High $10,964.78 | Professional | None | $7,244.36 | $10,964.78 | $10,964.78 |
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 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $8,511.38 Typical High $15,135.61 | Facility | None | $758.58 | $8,511.38 | $15,135.61 |
Denver HMP Setting Facility Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $15,488.17 | Facility | None | $10,964.78 | $10,964.78 | $15,488.17 |
Select Health Setting Facility Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $13,182.57 | Facility | None | $12,302.69 | $12,302.69 | $13,182.57 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $10,000.00 Typical High $22,387.21 | Facility | None | $4,570.88 | $10,000.00 | $22,387.21 |
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 $5,495.41 Median $5,495.41 Typical High $5,495.41 | Professional | 52 · Reduced service | $5,495.41 | $5,495.41 | $5,495.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | 53 · Discontinued | $2,187.76 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Professional | 54 · Surgery only | $8,128.31 | $8,128.31 | $8,128.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 55 · Aftercare only | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 56 · Pre-op care only | $1,096.48 | $1,096.48 | $1,096.48 |
Where Colorado sits
The same service costs 229.1 times more in Wyoming than in Montana. 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· 4th of 51
$15,136
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.