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 $1,513.56 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,513.56 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,318.26 | $1,659.59 |
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 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $3,630.78 | Professional | None | $1,584.89 | $2,089.30 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $12,882.50 Typical High $22,908.68 | Facility | None | $1,023.29 | $12,882.50 | $22,908.68 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,691.53 | Professional | None | $2,344.23 | $2,344.23 | $2,691.53 |
Denver HMP Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,905.46 | Facility | None | $1,318.26 | $1,318.26 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,584.89 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $2,398.83 Typical High $20,417.38 | Facility | None | $1,202.26 | $2,398.83 | $20,417.38 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,737.80 | Professional | None | $851.14 | $1,202.26 | $1,737.80 |
United Setting Facility Modifier None Typical Low $7,413.10 Median $17,782.79 Typical High $42,657.95 | Facility | None | $7,413.10 | $17,782.79 | $42,657.95 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,819.70 | $2,818.38 |
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 $660.69 Median $660.69 Typical High $758.58 | Professional | 52 · Reduced service | $660.69 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $302.00 | Professional | 53 · Discontinued | $263.03 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $223.87 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $151.36 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $151.36 |
Where Colorado sits
The same service costs 6.9 times more in Arkansas than in Kentucky. 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· 7th of 51
$3,311
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.