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 $2,570.40 Median $5,495.41 Typical High $12,589.25 | Facility | None | $2,570.40 | $5,495.41 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $7,762.47 | Professional | None | $363.08 | $363.08 | $7,762.47 |
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 $537.03 Median $724.44 Typical High $1,148.15 | Professional | None | $537.03 | $724.44 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $21,877.62 Typical High $39,810.72 | Facility | None | $758.58 | $21,877.62 | $39,810.72 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Denver HMP Setting Facility Modifier None Typical Low $354.81 Median $363.08 Typical High $812.83 | Facility | None | $354.81 | $363.08 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $660.69 | Professional | None | $309.03 | $467.74 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $660.69 Typical High $34,673.69 | Facility | None | $331.13 | $660.69 | $34,673.69 |
Select Health Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $331.13 | Professional | None | $229.09 | $229.09 | $331.13 |
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 $724.44 Median $1,230.27 Typical High $2,041.74 | Professional | None | $724.44 | $1,230.27 | $2,041.74 |
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 $181.97 Median $181.97 Typical High $389.05 | Professional | 52 · Reduced service | $181.97 | $181.97 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $154.88 | Professional | 53 · Discontinued | $72.44 | $72.44 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $575.44 | Professional | 54 · Surgery only | $269.15 | $269.15 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $114.82 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $77.62 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $77.62 |
Where Colorado sits
The same service costs 50.1 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· 5th of 51
$8,913
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.