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 $2,570.40 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $79.43 Typical High $104.71 | Professional | None | $69.18 | $79.43 | $104.71 |
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 $81.28 Median $109.65 Typical High $190.55 | Professional | None | $81.28 | $109.65 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $512.86 Typical High $891.25 | Facility | None | $52.48 | $512.86 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $120.23 | Professional | None | $77.62 | $91.20 | $120.23 |
Denver HMP Setting Facility Modifier None Typical Low $72.44 Median $91.20 Typical High $114.82 | Facility | None | $72.44 | $91.20 | $114.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $204.17 | Professional | None | $56.23 | $56.23 | $204.17 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $676.08 | Facility | None | $630.96 | $630.96 | $676.08 |
Select Health Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $66.07 | Professional | None | $56.23 | $56.23 | $66.07 |
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 $77.62 Median $95.50 Typical High $154.88 | Professional | None | $77.62 | $95.50 | $154.88 |
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 $36.31 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $36.31 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $14.45 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $60.26 Typical High $60.26 | Professional | 54 · Surgery only | $54.95 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $10.96 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.24 | $7.94 | $7.94 |
Where Colorado sits
The same service costs 5.5 times more in Arkansas 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· 7th of 51
$155
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.