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 $257.04 Median $275.42 Typical High $5,495.41 | Professional | None | $257.04 | $275.42 | $5,495.41 |
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 $309.03 Median $436.52 Typical High $645.65 | Professional | None | $309.03 | $436.52 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,148.15 Typical High $1,659.59 | Facility | None | $512.86 | $1,148.15 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Denver HMP Setting Facility Modifier None Typical Low $269.15 Median $275.42 Typical High $389.05 | Facility | None | $269.15 | $275.42 | $389.05 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,949.84 | Facility | None | $239.88 | $616.60 | $1,949.84 |
United Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $630.96 | Professional | None | $316.23 | $407.38 | $630.96 |
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 $125.89 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $125.89 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $51.29 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $190.55 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $38.02 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $25.70 | $27.54 | $27.54 |
Where Colorado sits
The same service costs 8.3 times more in Alaska 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· 5th of 51
$537
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.