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 $3,090.30 Median $5,495.41 Typical High $16,218.10 | Facility | None | $3,090.30 | $5,495.41 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $8,511.38 | Professional | None | $426.58 | $426.58 | $8,511.38 |
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 $489.78 Median $645.65 Typical High $1,000.00 | Professional | None | $489.78 | $645.65 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $15,848.93 Typical High $28,183.83 | Facility | None | $758.58 | $15,848.93 | $28,183.83 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Denver HMP Setting Facility Modifier None Typical Low $416.87 Median $426.58 Typical High $707.95 | Facility | None | $416.87 | $426.58 | $707.95 |
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 $24,547.09 | Facility | None | $416.87 | $831.76 | $24,547.09 |
Select Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $416.87 | Professional | None | $295.12 | $295.12 | $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 $741.31 Median $933.25 Typical High $1,513.56 | Professional | None | $741.31 | $933.25 | $1,513.56 |
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 $213.80 Median $213.80 Typical High $302.00 | Professional | 52 · Reduced service | $213.80 | $213.80 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $120.23 | Professional | 53 · Discontinued | $85.11 | $85.11 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $446.68 | Professional | 54 · Surgery only | $316.23 | $316.23 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $89.13 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $60.26 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $60.26 |
Where Colorado sits
The same service costs 27.5 times more in Oklahoma 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· 6th of 51
$4,786
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.