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 $416.87 Median $416.87 Typical High $588.84 | Professional | None | $416.87 | $416.87 | $588.84 |
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 $416.87 Median $562.34 Typical High $1,023.29 | Professional | None | $416.87 | $562.34 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,137.96 Typical High $2,691.53 | Facility | None | $630.96 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,202.26 | Professional | None | $616.60 | $616.60 | $1,202.26 |
Denver HMP Setting Facility Modifier None Typical Low $371.54 Median $416.87 Typical High $602.56 | Facility | None | $371.54 | $416.87 | $602.56 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $4,265.80 Typical High $13,182.57 | Facility | None | $1,905.46 | $4,265.80 | $13,182.57 |
United Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $602.56 | Professional | None | $302.00 | $380.19 | $602.56 |
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 $190.55 Median $208.93 Typical High $213.80 | Professional | 52 · Reduced service | $190.55 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $83.18 Typical High $85.11 | Professional | 53 · Discontinued | $75.86 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $302.00 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $63.10 Typical High $64.57 | Professional | 55 · Aftercare only | $56.23 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $41.69 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.02 | $41.69 | $42.66 |
Where Colorado sits
The same service costs 7.8 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· 7th of 51
$1,288
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.