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 $95.50 Median $3,162.28 Typical High $7,762.47 | Facility | None | $95.50 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $131.83 Typical High $245.47 | Professional | None | $56.23 | $131.83 | $245.47 |
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 $67.61 Median $165.96 Typical High $323.59 | Professional | None | $67.61 | $165.96 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $251.19 Typical High $1,659.59 | Facility | None | $147.91 | $251.19 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $134.90 Typical High $223.87 | Professional | None | $67.61 | $134.90 | $223.87 |
Denver HMP Setting Facility Modifier None Typical Low $56.23 Median $117.49 Typical High $229.09 | Facility | None | $56.23 | $117.49 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $107.15 Typical High $263.03 | Professional | None | $56.23 | $107.15 | $263.03 |
Select Health Setting Facility Modifier None Typical Low $93.33 Median $177.83 Typical High $331.13 | Facility | None | $93.33 | $177.83 | $331.13 |
Select Health Setting Professional Modifier None Typical Low $32.36 Median $57.54 Typical High $158.49 | Professional | None | $32.36 | $57.54 | $158.49 |
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 $64.57 Median $144.54 Typical High $257.04 | Professional | None | $64.57 | $144.54 | $257.04 |
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 $28.18 Median $61.66 Typical High $79.43 | Professional | 52 · Reduced service | $28.18 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $24.55 Typical High $31.62 | Professional | 53 · Discontinued | $11.48 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $91.20 Typical High $120.23 | Professional | 54 · Surgery only | $42.66 | $91.20 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $18.20 Typical High $23.99 | Professional | 55 · Aftercare only | $8.51 | $18.20 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $12.30 Typical High $15.85 | Professional | 56 · Pre-op care only | $5.62 | $12.30 | $15.85 |
Where Colorado sits
The same service costs 2.6 times more in Alaska than in Montana. 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· 8th of 51
$186
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.