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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $398.11 | Professional | None | $64.57 | $97.72 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $223.87 | Professional | None | $79.43 | $123.03 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $83.18 Typical High $831.76 | Facility | None | $64.57 | $83.18 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $323.59 | Professional | None | $112.20 | $158.49 | $323.59 |
Denver HMP Setting Facility Modifier None Typical Low $64.57 Median $97.72 Typical High $141.25 | Facility | None | $64.57 | $97.72 | $141.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $104.71 Typical High $165.96 | Professional | None | $61.66 | $104.71 | $165.96 |
Select Health Setting Facility Modifier None Typical Low $85.11 Median $104.71 Typical High $218.78 | Facility | None | $85.11 | $104.71 | $218.78 |
Select Health Setting Professional Modifier None Typical Low $39.81 Median $70.79 Typical High $104.71 | Professional | None | $39.81 | $70.79 | $104.71 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $190.55 | Professional | None | $74.13 | $114.82 | $190.55 |
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 $32.36 Median $42.66 Typical High $50.12 | Professional | 52 · Reduced service | $32.36 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $17.38 Typical High $19.95 | Professional | 53 · Discontinued | $12.88 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $64.57 Typical High $75.86 | Professional | 54 · Surgery only | $47.86 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.88 Typical High $15.14 | Professional | 55 · Aftercare only | $9.55 | $12.88 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.71 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.46 | $8.71 | $10.00 |
Where Colorado sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 15th of 51
$138
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.