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 $1,148.15 Median $3,388.44 Typical High $8,709.64 | Facility | None | $1,148.15 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $5,495.41 | Professional | None | $213.80 | $213.80 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $501.19 | Professional | None | $239.88 | $338.84 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,137.96 Typical High $2,818.38 | Facility | None | $758.58 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Denver HMP Setting Facility Modifier None Typical Low $213.80 Median $245.47 Typical High $331.13 | Facility | None | $213.80 | $245.47 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $239.88 Typical High $457.09 | Professional | None | $125.89 | $239.88 | $457.09 |
Select Health Setting Facility Modifier None Typical Low $229.09 Median $512.86 Typical High $2,454.71 | Facility | None | $229.09 | $512.86 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $79.43 Median $218.78 Typical High $549.54 | Professional | None | $79.43 | $218.78 | $549.54 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,182.57 | Facility | None | $1,949.84 | $4,265.80 | $13,182.57 |
United Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $478.63 | Professional | None | $234.42 | $302.00 | $478.63 |
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 $100.00 Median $107.15 Typical High $120.23 | Professional | 52 · Reduced service | $100.00 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $43.65 Typical High $47.86 | Professional | 53 · Discontinued | $39.81 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $162.18 Typical High $177.83 | Professional | 54 · Surgery only | $151.36 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $32.36 Typical High $35.48 | Professional | 55 · Aftercare only | $30.20 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.38 Typical High $23.99 | Professional | 56 · Pre-op care only | $19.95 | $21.38 | $23.99 |
Where Colorado sits
The same service costs 19.5 times more in Texas 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· 19th of 51
$437
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.