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 $645.65 Median $660.69 Typical High $7,244.36 | Professional | None | $645.65 | $660.69 | $7,244.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $7,585.78 Typical High $22,387.21 | Facility | None | $5,248.07 | $7,585.78 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,778.28 | Professional | None | $831.76 | $1,122.02 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,495.41 Typical High $9,772.37 | Facility | None | $758.58 | $5,495.41 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Denver HMP Setting Facility Modifier None Typical Low $446.68 Median $660.69 Typical High $933.25 | Facility | None | $446.68 | $660.69 | $933.25 |
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 $8,511.38 | Facility | None | $302.00 | $602.56 | $8,511.38 |
Select Health Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $302.00 | Professional | None | $208.93 | $208.93 | $302.00 |
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 $426.58 Median $562.34 Typical High $1,230.27 | Professional | None | $426.58 | $562.34 | $1,230.27 |
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 $275.42 Median $331.13 Typical High $363.08 | Professional | 52 · Reduced service | $275.42 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $131.83 Typical High $144.54 | Professional | 53 · Discontinued | $109.65 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $489.78 Typical High $549.54 | Professional | 54 · Surgery only | $407.38 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $97.72 Typical High $109.65 | Professional | 55 · Aftercare only | $83.18 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $66.07 Typical High $72.44 | Professional | 56 · Pre-op care only | $54.95 | $66.07 | $72.44 |
Where Colorado sits
The same service costs 14.8 times more in Texas 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· 7th of 51
$2,818
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.