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 $117.49 Median $3,235.94 Typical High $8,912.51 | Facility | None | $117.49 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $85.11 Typical High $154.88 | Professional | None | $45.71 | $85.11 | $154.88 |
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 $54.95 Median $123.03 Typical High $239.88 | Professional | None | $54.95 | $123.03 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $107.15 Typical High $194.98 | Facility | None | $52.48 | $107.15 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $83.18 Typical High $162.18 | Professional | None | $46.77 | $83.18 | $162.18 |
Denver HMP Setting Facility Modifier None Typical Low $45.71 Median $91.20 Typical High $169.82 | Facility | None | $45.71 | $91.20 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $77.62 Typical High $194.98 | Professional | None | $43.65 | $77.62 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $74.13 Median $128.82 Typical High $245.47 | Facility | None | $74.13 | $128.82 | $245.47 |
Select Health Setting Professional Modifier None Typical Low $25.70 Median $45.71 Typical High $117.49 | Professional | None | $25.70 | $45.71 | $117.49 |
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 $48.98 Median $95.50 Typical High $204.17 | Professional | None | $48.98 | $95.50 | $204.17 |
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 $22.91 Median $43.65 Typical High $58.88 | Professional | 52 · Reduced service | $22.91 | $43.65 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $17.38 Typical High $23.44 | Professional | 53 · Discontinued | $9.12 | $17.38 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $64.57 Typical High $89.13 | Professional | 54 · Surgery only | $33.88 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $12.88 Typical High $17.78 | Professional | 55 · Aftercare only | $6.76 | $12.88 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $8.71 Typical High $11.75 | Professional | 56 · Pre-op care only | $4.57 | $8.71 | $11.75 |
Where Colorado sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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
$126
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.