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 $3,162.28 Typical High $8,912.51 | Facility | None | $117.49 | $3,162.28 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $117.49 Typical High $181.97 | Professional | None | $74.13 | $117.49 | $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 $89.13 Median $173.78 Typical High $323.59 | Professional | None | $89.13 | $173.78 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $131.83 Typical High $239.88 | Facility | None | $52.48 | $131.83 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $223.87 | Professional | None | $79.43 | $125.89 | $223.87 |
Denver HMP Setting Facility Modifier None Typical Low $75.86 Median $144.54 Typical High $229.09 | Facility | None | $75.86 | $144.54 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $125.89 Typical High $269.15 | Professional | None | $72.44 | $125.89 | $269.15 |
Select Health Setting Facility Modifier None Typical Low $123.03 Median $162.18 Typical High $331.13 | Facility | None | $123.03 | $162.18 | $331.13 |
Select Health Setting Professional Modifier None Typical Low $42.66 Median $75.86 Typical High $158.49 | Professional | None | $42.66 | $75.86 | $158.49 |
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 $81.28 Median $147.91 Typical High $281.84 | Professional | None | $81.28 | $147.91 | $281.84 |
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 $37.15 Median $61.66 Typical High $79.43 | Professional | 52 · Reduced service | $37.15 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $25.12 Typical High $31.62 | Professional | 53 · Discontinued | $15.14 | $25.12 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $93.33 Typical High $120.23 | Professional | 54 · Surgery only | $56.23 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $18.62 Typical High $23.99 | Professional | 55 · Aftercare only | $11.22 | $18.62 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $12.30 Typical High $15.85 | Professional | 56 · Pre-op care only | $7.59 | $12.30 | $15.85 |
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
$178
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.