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 $2,691.53 Median $6,025.60 Typical High $12,882.50 | Facility | None | $2,691.53 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $12,882.50 | Professional | None | $331.13 | $407.38 | $12,882.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $15,848.93 Median $20,892.96 Typical High $63,095.73 | Facility | None | $15,848.93 | $20,892.96 | $63,095.73 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $870.96 | Professional | None | $407.38 | $549.54 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $20,892.96 Typical High $37,153.52 | Facility | None | $758.58 | $20,892.96 | $37,153.52 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Denver HMP Setting Facility Modifier None Typical Low $354.81 Median $363.08 Typical High $512.86 | Facility | None | $354.81 | $363.08 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $630.96 | Professional | None | $302.00 | $446.68 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $316.23 Median $630.96 Typical High $32,359.37 | Facility | None | $316.23 | $630.96 | $32,359.37 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $316.23 | Professional | None | $223.87 | $223.87 | $316.23 |
United Setting Facility Modifier None Typical Low $11,220.18 Median $29,512.09 Typical High $52,480.75 | Facility | None | $11,220.18 | $29,512.09 | $52,480.75 |
United Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $912.01 | Professional | None | $457.09 | $588.84 | $912.01 |
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 $169.82 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $169.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $67.61 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $257.04 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $51.29 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $33.88 | $36.31 | $36.31 |
Where Colorado sits
The same service costs 63.1 times more in Arkansas than in New York. 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· 5th of 51
$10,471
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.