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 $229.09 Median $245.47 Typical High $7,244.36 | Professional | None | $229.09 | $245.47 | $7,244.36 |
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 $263.03 Median $346.74 Typical High $549.54 | Professional | None | $263.03 | $346.74 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,691.53 Typical High $3,981.07 | Facility | None | $758.58 | $2,691.53 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Denver HMP Setting Facility Modifier None Typical Low $239.88 Median $245.47 Typical High $346.74 | Facility | None | $239.88 | $245.47 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $426.58 | Professional | None | $204.17 | $302.00 | $426.58 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $426.58 Typical High $3,467.37 | Facility | None | $213.80 | $426.58 | $3,467.37 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $213.80 | Professional | None | $151.36 | $151.36 | $213.80 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $575.44 | Professional | None | $288.40 | $371.54 | $575.44 |
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 $112.20 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $112.20 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $45.71 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $181.97 Typical High $181.97 | Professional | 54 · Surgery only | $169.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $33.88 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $22.39 | $24.55 | $24.55 |
Where Colorado sits
The same service costs 10.7 times more in Colorado 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· 1st of 51
$2,512
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.