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 $87.10 Median $3,235.94 Typical High $7,762.47 | Facility | None | $87.10 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $102.33 Typical High $177.83 | Professional | None | $54.95 | $102.33 | $177.83 |
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 $69.18 Median $125.89 Typical High $213.80 | Professional | None | $69.18 | $125.89 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $85.11 Typical High $147.91 | Facility | None | $52.48 | $85.11 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $120.23 Typical High $181.97 | Professional | None | $75.86 | $120.23 | $181.97 |
Denver HMP Setting Facility Modifier None Typical Low $54.95 Median $102.33 Typical High $186.21 | Facility | None | $54.95 | $102.33 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $50.12 Median $102.33 Typical High $177.83 | Professional | None | $50.12 | $102.33 | $177.83 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $104.71 Typical High $218.78 | Facility | None | $91.20 | $104.71 | $218.78 |
Select Health Setting Professional Modifier None Typical Low $32.36 Median $89.13 Typical High $204.17 | Professional | None | $32.36 | $89.13 | $204.17 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $72.44 Median $123.03 Typical High $208.93 | Professional | None | $72.44 | $123.03 | $208.93 |
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 $27.54 Median $38.90 Typical High $51.29 | Professional | 52 · Reduced service | $27.54 | $38.90 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $15.85 Typical High $20.89 | Professional | 53 · Discontinued | $10.96 | $15.85 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $58.88 Typical High $77.62 | Professional | 54 · Surgery only | $41.69 | $58.88 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $11.75 Typical High $15.49 | Professional | 55 · Aftercare only | $8.32 | $11.75 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.94 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.50 | $7.94 | $10.23 |
Where Colorado sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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· 12th of 51
$138
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.