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 $1,995.26 Median $5,495.41 Typical High $10,964.78 | Facility | None | $1,995.26 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $6,025.60 Median $7,244.36 Typical High $10,232.93 | Professional | None | $6,025.60 | $7,244.36 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $11,481.54 Median $16,982.44 Typical High $38,904.51 | Facility | None | $11,481.54 | $16,982.44 | $38,904.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $6,760.83 Median $9,120.11 Typical High $14,791.08 | Professional | None | $6,760.83 | $9,120.11 | $14,791.08 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $9,120.11 Typical High $16,218.10 | Facility | None | $758.58 | $9,120.11 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $9,772.37 | Professional | None | $9,772.37 | $9,772.37 | $9,772.37 |
Denver HMP Setting Facility Modifier None Typical Low $3,801.89 Median $7,244.36 Typical High $10,232.93 | Facility | None | $3,801.89 | $7,244.36 | $10,232.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $1,445.44 Typical High $18,620.87 | Professional | None | $588.84 | $1,445.44 | $18,620.87 |
Select Health Setting Facility Modifier None Typical Low $1,122.02 Median $13,182.57 Typical High $23,442.29 | Facility | None | $1,122.02 | $13,182.57 | $23,442.29 |
Select Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $11,220.18 | Professional | None | $389.05 | $389.05 | $11,220.18 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $10,000.00 Typical High $22,387.21 | Facility | None | $4,570.88 | $10,000.00 | $22,387.21 |
United Setting Professional Modifier None Typical Low $12,589.25 Median $16,218.10 Typical High $25,118.86 | Professional | None | $12,589.25 | $16,218.10 | $25,118.86 |
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 $3,090.30 Median $3,630.78 Typical High $5,011.87 | Professional | 52 · Reduced service | $3,090.30 | $3,630.78 | $5,011.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,230.27 Median $1,445.44 Typical High $2,041.74 | Professional | 53 · Discontinued | $1,230.27 | $1,445.44 | $2,041.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,677.35 Median $5,370.32 Typical High $7,585.78 | Professional | 54 · Surgery only | $4,677.35 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $933.25 Median $1,071.52 Typical High $1,513.56 | Professional | 55 · Aftercare only | $933.25 | $1,071.52 | $1,513.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $616.60 Median $724.44 Typical High $1,023.29 | Professional | 56 · Pre-op care only | $616.60 | $724.44 | $1,023.29 |
Where Colorado sits
The same service costs 16.6 times more in Indiana than in Nebraska. 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· 15th of 51
$12,023
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.