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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $6,456.54 | Professional | None | $331.13 | $331.13 | $6,456.54 |
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 $602.56 Median $831.76 Typical High $1,288.25 | Professional | None | $602.56 | $831.76 | $1,288.25 |
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 $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Denver HMP Setting Facility Modifier None Typical Low $323.59 Median $331.13 Typical High $676.08 | Facility | None | $323.59 | $331.13 | $676.08 |
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 $3,467.37 | Facility | None | $302.00 | $602.56 | $3,467.37 |
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 $645.65 Median $870.96 Typical High $1,445.44 | Professional | None | $645.65 | $870.96 | $1,445.44 |
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 $165.96 Median $165.96 Typical High $281.84 | Professional | 52 · Reduced service | $165.96 | $165.96 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $112.20 | Professional | 53 · Discontinued | $66.07 | $66.07 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $426.58 | Professional | 54 · Surgery only | $245.47 | $245.47 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $85.11 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $56.23 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $56.23 |
Where Colorado sits
The same service costs 10.2 times more in Texas 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· 2nd of 51
$2,570
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.