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 $1,148.15 Median $3,388.44 Typical High $8,709.64 | Facility | None | $1,148.15 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $812.83 Typical High $5,495.41 | Professional | None | $131.83 | $812.83 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $302.00 | Professional | None | $144.54 | $204.17 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $588.84 Typical High $2,187.76 | Facility | None | $398.11 | $588.84 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Denver HMP Setting Facility Modifier None Typical Low $128.82 Median $812.83 Typical High $2,818.38 | Facility | None | $128.82 | $812.83 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $398.11 Typical High $3,630.78 | Professional | None | $125.89 | $398.11 | $3,630.78 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $512.86 Typical High $4,466.84 | Facility | None | $223.87 | $512.86 | $4,466.84 |
Select Health Setting Professional Modifier None Typical Low $79.43 Median $218.78 Typical High $4,168.69 | Professional | None | $79.43 | $218.78 | $4,168.69 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,174.90 Typical High $2,951.21 | Facility | None | $489.78 | $1,174.90 | $2,951.21 |
United Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $346.74 | Professional | None | $169.82 | $223.87 | $346.74 |
4 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 $64.57 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $64.57 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $25.70 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $19.50 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $12.88 | $81.28 | $81.28 |
Where Colorado sits
The same service costs 24.5 times more in Texas than in Missouri. 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· 9th of 51
$457
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.