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 $489.78 Median $501.19 Typical High $501.19 | Professional | None | $489.78 | $501.19 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $15,135.61 Typical High $25,703.96 | Facility | None | $10,000.00 | $15,135.61 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $1,174.90 | Professional | None | $575.44 | $794.33 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,248.07 Typical High $9,332.54 | Facility | None | $758.58 | $5,248.07 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $2,454.71 | Professional | None | $812.83 | $812.83 | $2,454.71 |
Denver HMP Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $724.44 | Facility | None | $501.19 | $501.19 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $346.74 | Professional | None | $154.88 | $154.88 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $8,128.31 | Facility | None | $7,585.78 | $7,585.78 | $8,128.31 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,762.47 | Facility | None | $1,288.25 | $2,511.89 | $7,762.47 |
United Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $1,047.13 | Professional | None | $524.81 | $676.08 | $1,047.13 |
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 $245.47 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $245.47 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $97.72 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $363.08 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $48.98 | $50.12 | $50.12 |
Where Colorado sits
The same service costs 7.2 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· 13th of 51
$933
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.