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 $48.98 Median $3,090.30 Typical High $7,762.47 | Facility | None | $48.98 | $3,090.30 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $70.79 Typical High $138.04 | Professional | None | $38.02 | $70.79 | $138.04 |
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 $44.67 Median $93.33 Typical High $181.97 | Professional | None | $44.67 | $93.33 | $181.97 |
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 $38.02 Median $74.13 Typical High $123.03 | Professional | None | $38.02 | $74.13 | $123.03 |
Denver HMP Setting Facility Modifier None Typical Low $38.02 Median $83.18 Typical High $125.89 | Facility | None | $38.02 | $83.18 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $75.86 Typical High $154.88 | Professional | None | $43.65 | $75.86 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $72.44 Median $95.50 Typical High $199.53 | Facility | None | $72.44 | $95.50 | $199.53 |
Select Health Setting Professional Modifier None Typical Low $25.12 Median $44.67 Typical High $95.50 | Professional | None | $25.12 | $44.67 | $95.50 |
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 $40.74 Median $81.28 Typical High $144.54 | Professional | None | $40.74 | $81.28 | $144.54 |
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 $19.05 Median $33.88 Typical High $43.65 | Professional | 52 · Reduced service | $19.05 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $13.49 Typical High $17.38 | Professional | 53 · Discontinued | $7.59 | $13.49 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $50.12 Typical High $66.07 | Professional | 54 · Surgery only | $28.84 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $10.00 Typical High $13.18 | Professional | 55 · Aftercare only | $5.75 | $10.00 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $6.76 Typical High $8.71 | Professional | 56 · Pre-op care only | $3.80 | $6.76 | $8.71 |
Where Colorado sits
The same service costs 3.7 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· 11th of 51
$97.72
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.