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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $6,025.60 | Professional | None | $1,202.26 | $1,288.25 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,318.26 | $1,778.28 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,630.27 Typical High $3,715.35 | Facility | None | $691.83 | $2,630.27 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,479.11 | $1,949.84 |
Denver HMP Setting Facility Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $1,819.70 | Facility | None | $1,288.25 | $1,513.56 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Professional | None | $10,000.00 | $10,000.00 | $10,000.00 |
Select Health Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,235.94 | Facility | None | $3,019.95 | $3,019.95 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,318.26 | $1,584.89 | $2,511.89 |
6 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 $588.84 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $588.84 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $257.04 Typical High $263.03 | Professional | 53 · Discontinued | $234.42 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $954.99 Typical High $977.24 | Professional | 54 · Surgery only | $891.25 | $954.99 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $190.55 Typical High $194.98 | Professional | 55 · Aftercare only | $177.83 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $117.49 | $128.82 | $128.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,513.56 Typical High $2,570.40 | Professional | 50 · Both sides | $1,174.90 | $1,513.56 | $2,570.40 |
Where Colorado sits
The same service costs 4.8 times more in Alaska than in New York. 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· 10th of 51
$2,344
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.