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 $141.25 Median $3,235.94 Typical High $8,912.51 | Facility | None | $141.25 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $102.33 Typical High $181.97 | Professional | None | $63.10 | $102.33 | $181.97 |
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 $74.13 Median $151.36 Typical High $281.84 | Professional | None | $74.13 | $151.36 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $117.49 Typical High $213.80 | Facility | None | $52.48 | $117.49 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $186.21 | Professional | None | $69.18 | $107.15 | $186.21 |
Denver HMP Setting Facility Modifier None Typical Low $63.10 Median $125.89 Typical High $199.53 | Facility | None | $63.10 | $125.89 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $107.15 Typical High $234.42 | Professional | None | $61.66 | $107.15 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $102.33 Median $144.54 Typical High $288.40 | Facility | None | $102.33 | $144.54 | $288.40 |
Select Health Setting Professional Modifier None Typical Low $35.48 Median $63.10 Typical High $138.04 | Professional | None | $35.48 | $63.10 | $138.04 |
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 $69.18 Median $123.03 Typical High $218.78 | Professional | None | $69.18 | $123.03 | $218.78 |
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 $31.62 Median $54.95 Typical High $70.79 | Professional | 52 · Reduced service | $31.62 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $21.88 Typical High $28.18 | Professional | 53 · Discontinued | $12.59 | $21.88 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $81.28 Typical High $104.71 | Professional | 54 · Surgery only | $47.86 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $16.22 Typical High $20.89 | Professional | 55 · Aftercare only | $9.55 | $16.22 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $10.96 Typical High $14.13 | Professional | 56 · Pre-op care only | $6.31 | $10.96 | $14.13 |
Where Colorado sits
The same service costs 3.2 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
$151
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.