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 $18,197.01 | Facility | None | $1,995.26 | $5,495.41 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $7,244.36 Median $18,197.01 Typical High $18,197.01 | Professional | None | $7,244.36 | $18,197.01 | $18,197.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $15,848.93 Median $20,892.96 Typical High $50,118.72 | Facility | None | $15,848.93 | $20,892.96 | $50,118.72 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $14,791.08 Typical High $26,915.35 | Facility | None | $758.58 | $14,791.08 | $26,915.35 |
Denver HMP Setting Facility Modifier None Typical Low $18,197.01 Median $18,197.01 Typical High $25,703.96 | Facility | None | $18,197.01 | $18,197.01 | $25,703.96 |
Select Health Setting Facility Modifier None Typical Low $21,877.62 Median $21,877.62 Typical High $23,442.29 | Facility | None | $21,877.62 | $21,877.62 | $23,442.29 |
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 $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | 52 · Reduced service | $8,912.51 | $8,912.51 | $8,912.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | 53 · Discontinued | $3,630.78 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13,489.63 Median $13,489.63 Typical High $13,489.63 | Professional | 54 · Surgery only | $13,489.63 | $13,489.63 | $13,489.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | 55 · Aftercare only | $2,691.53 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 56 · Pre-op care only | $1,819.70 | $1,819.70 | $1,819.70 |
Where Colorado sits
The same service costs 323.6 times more in Alaska 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
$18,621
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.