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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $851.14 | Professional | None | $758.58 | $776.25 | $851.14 |
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 $851.14 Median $1,122.02 Typical High $1,949.84 | Professional | None | $851.14 | $1,122.02 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,897.79 Typical High $7,585.78 | Facility | None | $758.58 | $4,897.79 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,258.93 | Professional | None | $1,202.26 | $1,202.26 | $1,258.93 |
Denver HMP Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $1,122.02 | Facility | None | $776.25 | $776.25 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,202.26 | Professional | None | $676.08 | $870.96 | $1,202.26 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $1,348.96 Typical High $6,606.93 | Facility | None | $676.08 | $1,348.96 | $6,606.93 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $977.24 | Professional | None | $467.74 | $676.08 | $977.24 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,584.89 | Professional | None | $741.31 | $1,000.00 | $1,584.89 |
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 $363.08 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $363.08 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $147.91 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $549.54 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $109.65 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $75.86 | $77.62 | $77.62 |
Where Colorado sits
The same service costs 5.1 times more in Texas than in Delaware. 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· 10th of 51
$1,820
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.