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 $154.88 Median $3,235.94 Typical High $8,912.51 | Facility | None | $154.88 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $123.03 Typical High $199.53 | Professional | None | $70.79 | $123.03 | $199.53 |
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 $85.11 Median $169.82 Typical High $316.23 | Professional | None | $85.11 | $169.82 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,698.24 | Facility | None | $50.12 | $66.07 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $213.80 | Professional | None | $79.43 | $128.82 | $213.80 |
Denver HMP Setting Facility Modifier None Typical Low $72.44 Median $141.25 Typical High $223.87 | Facility | None | $72.44 | $141.25 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $123.03 Typical High $263.03 | Professional | None | $69.18 | $123.03 | $263.03 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $154.88 Typical High $323.59 | Facility | None | $117.49 | $154.88 | $323.59 |
Select Health Setting Professional Modifier None Typical Low $40.74 Median $72.44 Typical High $154.88 | Professional | None | $40.74 | $72.44 | $154.88 |
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 $79.43 Median $144.54 Typical High $275.42 | Professional | None | $79.43 | $144.54 | $275.42 |
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 $36.31 Median $60.26 Typical High $77.62 | Professional | 52 · Reduced service | $36.31 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $24.55 Typical High $30.90 | Professional | 53 · Discontinued | $14.45 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $91.20 Typical High $117.49 | Professional | 54 · Surgery only | $53.70 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $18.20 Typical High $23.44 | Professional | 55 · Aftercare only | $10.72 | $18.20 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $12.02 Typical High $15.49 | Professional | 56 · Pre-op care only | $7.24 | $12.02 | $15.49 |
Where Colorado sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$174
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.