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 $467.74 Median $467.74 Typical High $7,244.36 | Professional | None | $467.74 | $467.74 | $7,244.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $15,848.93 Median $20,892.96 Typical High $53,703.18 | Facility | None | $15,848.93 | $20,892.96 | $53,703.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,202.26 | Professional | None | $588.84 | $776.25 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $8,317.64 Typical High $15,135.61 | Facility | None | $758.58 | $8,317.64 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Denver HMP Setting Facility Modifier None Typical Low $457.09 Median $467.74 Typical High $660.69 | Facility | None | $457.09 | $467.74 | $660.69 |
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 $13,182.57 | Facility | None | $416.87 | $831.76 | $13,182.57 |
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 $11,220.18 Median $28,840.32 Typical High $52,480.75 | Facility | None | $11,220.18 | $28,840.32 | $52,480.75 |
United Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $1,258.93 | Professional | None | $630.96 | $831.76 | $1,258.93 |
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 $234.42 Median $234.42 Typical High $263.03 | Professional | 52 · Reduced service | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $104.71 | Professional | 53 · Discontinued | $93.33 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $389.05 | Professional | 54 · Surgery only | $346.74 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $77.62 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $52.48 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $52.48 |
Where Colorado sits
The same service costs 24.0 times more in Arkansas than in New York. 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
$7,586
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.