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 $3,715.35 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $7,244.36 | Professional | None | $371.54 | $426.58 | $7,244.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $11,481.54 Median $16,982.44 Typical High $45,708.82 | Facility | None | $11,481.54 | $16,982.44 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $933.25 | Professional | None | $457.09 | $588.84 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $7,943.28 Typical High $14,454.40 | Facility | None | $758.58 | $7,943.28 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Denver HMP Setting Facility Modifier None Typical Low $380.19 Median $426.58 Typical High $602.56 | Facility | None | $380.19 | $426.58 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $831.76 | Professional | None | $398.11 | $588.84 | $831.76 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $831.76 Typical High $12,589.25 | Facility | None | $416.87 | $831.76 | $12,589.25 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $416.87 | Professional | None | $288.40 | $288.40 | $416.87 |
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 $389.05 Median $524.81 Typical High $912.01 | Professional | None | $389.05 | $524.81 | $912.01 |
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 $177.83 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $177.83 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $70.79 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $269.15 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $53.70 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $35.48 | $42.66 | $42.66 |
Where Colorado sits
The same service costs 16.2 times more in Arkansas than in West Virginia. 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· 3rd of 51
$4,571
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.