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 $186.21 Median $239.88 Typical High $3,235.94 | Professional | None | $186.21 | $239.88 | $3,235.94 |
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 $302.00 Median $302.00 Typical High $363.08 | Professional | None | $302.00 | $302.00 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $1,659.59 | Facility | None | $501.19 | $707.95 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Denver HMP Setting Facility Modifier None Typical Low $186.21 Median $239.88 Typical High $363.08 | Facility | None | $186.21 | $239.88 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $87.10 Typical High $223.87 | Professional | None | $45.71 | $87.10 | $223.87 |
Select Health Setting Facility Modifier None Typical Low $83.18 Median $269.15 Typical High $676.08 | Facility | None | $83.18 | $269.15 | $676.08 |
Select Health Setting Professional Modifier None Typical Low $29.51 Median $58.88 Typical High $144.54 | Professional | None | $29.51 | $58.88 | $144.54 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,174.90 Typical High $2,951.21 | Facility | None | $489.78 | $1,174.90 | $2,951.21 |
United Setting Professional Modifier None Typical Low $194.98 Median $346.74 Typical High $562.34 | Professional | None | $194.98 | $346.74 | $562.34 |
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 $120.23 Median $120.23 Typical High $151.36 | Professional | 52 · Reduced service | $120.23 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $60.26 | Professional | 53 · Discontinued | $47.86 | $47.86 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $229.09 | Professional | 54 · Surgery only | $177.83 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $45.71 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $30.20 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $30.20 |
Where Colorado sits
The same service costs 8.3 times more in Oklahoma than in Rhode Island. 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· 5th of 51
$646
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.