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 $46.77 Median $3,235.94 Typical High $7,762.47 | Facility | None | $46.77 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $52.48 Typical High $85.11 | Professional | None | $29.51 | $52.48 | $85.11 |
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 $36.31 Median $67.61 Typical High $117.49 | Professional | None | $36.31 | $67.61 | $117.49 |
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 $33.88 Median $52.48 Typical High $79.43 | Professional | None | $33.88 | $52.48 | $79.43 |
Denver HMP Setting Facility Modifier None Typical Low $29.51 Median $57.54 Typical High $85.11 | Facility | None | $29.51 | $57.54 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.84 Median $48.98 Typical High $100.00 | Professional | None | $28.84 | $48.98 | $100.00 |
Select Health Setting Facility Modifier None Typical Low $48.98 Median $58.88 Typical High $123.03 | Facility | None | $48.98 | $58.88 | $123.03 |
Select Health Setting Professional Modifier None Typical Low $16.98 Median $30.20 Typical High $58.88 | Professional | None | $16.98 | $30.20 | $58.88 |
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 $33.11 Median $57.54 Typical High $100.00 | Professional | None | $33.11 | $57.54 | $100.00 |
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 $14.79 Median $21.88 Typical High $29.51 | Professional | 52 · Reduced service | $14.79 | $21.88 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $8.71 Typical High $11.75 | Professional | 53 · Discontinued | $5.89 | $8.71 | $11.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $33.11 Typical High $44.67 | Professional | 54 · Surgery only | $22.39 | $33.11 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $6.61 Typical High $8.91 | Professional | 55 · Aftercare only | $4.47 | $6.61 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $4.37 Typical High $5.89 | Professional | 56 · Pre-op care only | $2.95 | $4.37 | $5.89 |
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· 13th of 51
$67.61
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.