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 $120.23 Median $3,090.30 Typical High $8,912.51 | Facility | None | $120.23 | $3,090.30 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $144.54 Typical High $213.80 | Professional | None | $93.33 | $144.54 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $331.13 | Professional | None | $112.20 | $190.55 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $208.93 Typical High $1,659.59 | Facility | None | $120.23 | $208.93 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $239.88 | Professional | None | $109.65 | $162.18 | $239.88 |
Denver HMP Setting Facility Modifier None Typical Low $93.33 Median $147.91 Typical High $234.42 | Facility | None | $93.33 | $147.91 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $281.84 | Professional | None | $102.33 | $162.18 | $281.84 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $165.96 Typical High $346.74 | Facility | None | $147.91 | $165.96 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $58.88 Median $104.71 Typical High $165.96 | Professional | None | $58.88 | $104.71 | $165.96 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $4,897.79 | Facility | None | $676.08 | $1,412.54 | $4,897.79 |
United Setting Professional Modifier None Typical Low $104.71 Median $169.82 Typical High $275.42 | Professional | None | $104.71 | $169.82 | $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 $46.77 Median $64.57 Typical High $81.28 | Professional | 52 · Reduced service | $46.77 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $25.70 Typical High $32.36 | Professional | 53 · Discontinued | $18.62 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $95.50 Typical High $123.03 | Professional | 54 · Surgery only | $70.79 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $19.05 Typical High $24.55 | Professional | 55 · Aftercare only | $14.13 | $19.05 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.88 Typical High $16.22 | Professional | 56 · Pre-op care only | $9.33 | $12.88 | $16.22 |
Where Colorado sits
The same service costs 3.2 times more in Alaska than in New Jersey. 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
$195
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.