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 $5,495.41 Typical High $12,882.50 | Facility | None | $2,691.53 | $5,495.41 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $8,128.31 | Professional | None | $363.08 | $363.08 | $8,128.31 |
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 $436.52 Median $575.44 Typical High $912.01 | Professional | None | $436.52 | $575.44 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $19,952.62 Typical High $36,307.81 | Facility | None | $758.58 | $19,952.62 | $36,307.81 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
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 $309.03 Median $467.74 Typical High $660.69 | Professional | None | $309.03 | $467.74 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $660.69 Typical High $31,622.78 | Facility | None | $331.13 | $660.69 | $31,622.78 |
Select Health Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $331.13 | Professional | None | $229.09 | $229.09 | $331.13 |
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 $501.19 Median $660.69 Typical High $1,000.00 | Professional | None | $501.19 | $660.69 | $1,000.00 |
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 $181.97 Median $181.97 Typical High $199.53 | Professional | 52 · Reduced service | $181.97 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $79.43 | Professional | 53 · Discontinued | $72.44 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $302.00 | Professional | 54 · Surgery only | $269.15 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $60.26 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $39.81 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $39.81 |
Where Colorado sits
The same service costs 57.5 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· 6th of 51
$8,913
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.