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 $954.99 Median $3,388.44 Typical High $8,709.64 | Facility | None | $954.99 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $77.62 | Professional | None | $40.74 | $44.67 | $77.62 |
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 $48.98 Median $63.10 Typical High $109.65 | Professional | None | $48.98 | $63.10 | $109.65 |
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 $47.86 Median $56.23 Typical High $77.62 | Professional | None | $47.86 | $56.23 | $77.62 |
Denver HMP Setting Facility Modifier None Typical Low $44.67 Median $58.88 Typical High $91.20 | Facility | None | $44.67 | $58.88 | $91.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $52.48 Typical High $77.62 | Professional | None | $38.90 | $52.48 | $77.62 |
Select Health Setting Facility Modifier None Typical Low $38.90 Median $70.79 Typical High $81.28 | Facility | None | $38.90 | $70.79 | $81.28 |
Select Health Setting Professional Modifier None Typical Low $26.92 Median $38.90 Typical High $53.70 | Professional | None | $26.92 | $38.90 | $53.70 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,995.26 | Facility | None | $239.88 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $47.86 Median $58.88 Typical High $93.33 | Professional | None | $47.86 | $58.88 | $93.33 |
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 $20.89 Median $22.39 Typical High $25.12 | Professional | 52 · Reduced service | $20.89 | $22.39 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.91 Typical High $10.00 | Professional | 53 · Discontinued | $8.32 | $8.91 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $33.11 Typical High $37.15 | Professional | 54 · Surgery only | $31.62 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.61 Typical High $7.41 | Professional | 55 · Aftercare only | $6.31 | $6.61 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.47 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.17 | $4.47 | $5.01 |
Where Colorado sits
The same service costs 13.8 times more in Oklahoma 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· 17th of 51
$83.18
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.