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 $2,570.40 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $316.23 Typical High $2,570.40 | Professional | None | $302.00 | $316.23 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $794.33 | Professional | None | $380.19 | $524.81 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $5,248.07 Typical High $34,673.69 | Facility | None | $1,513.56 | $5,248.07 | $34,673.69 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Denver HMP Setting Facility Modifier None Typical Low $309.03 Median $316.23 Typical High $457.09 | Facility | None | $309.03 | $316.23 | $457.09 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $776.25 | Professional | None | $389.05 | $501.19 | $776.25 |
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 $151.36 Median $158.49 Typical High $162.18 | Professional | 52 · Reduced service | $151.36 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $63.10 Typical High $64.57 | Professional | 53 · Discontinued | $61.66 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $239.88 Typical High $245.47 | Professional | 54 · Surgery only | $229.09 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $47.86 Typical High $48.98 | Professional | 55 · Aftercare only | $45.71 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $31.62 Typical High $32.36 | Professional | 56 · Pre-op care only | $30.20 | $31.62 | $32.36 |
Where Colorado sits
The same service costs 6.3 times more in Texas than in Pennsylvania. 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· 9th of 51
$661
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.