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 $331.13 Median $354.81 Typical High $7,244.36 | Professional | None | $331.13 | $354.81 | $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 $380.19 Median $501.19 Typical High $794.33 | Professional | None | $380.19 | $501.19 | $794.33 |
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 $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Denver HMP Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $512.86 | Facility | None | $354.81 | $354.81 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $602.56 | Professional | None | $288.40 | $426.58 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $602.56 Typical High $12,589.25 | Facility | None | $302.00 | $602.56 | $12,589.25 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $302.00 | Professional | None | $213.80 | $213.80 | $302.00 |
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 $407.38 Median $537.03 Typical High $812.83 | Professional | None | $407.38 | $537.03 | $812.83 |
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 $165.96 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $165.96 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $66.07 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $245.47 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $33.11 | $35.48 | $35.48 |
Where Colorado sits
The same service costs 15.8 times more in Arkansas than in Maine. 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· 4th 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.