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 $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $147.91 Typical High $288.40 | Professional | None | $67.61 | $147.91 | $288.40 |
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 $85.11 Median $173.78 Typical High $316.23 | Professional | None | $85.11 | $173.78 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,071.52 Typical High $1,659.59 | Facility | None | $436.52 | $1,071.52 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $147.91 Typical High $257.04 | Professional | None | $79.43 | $147.91 | $257.04 |
Denver HMP Setting Facility Modifier None Typical Low $67.61 Median $147.91 Typical High $213.80 | Facility | None | $67.61 | $147.91 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $138.04 Typical High $275.42 | Professional | None | $67.61 | $138.04 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $120.23 Median $309.03 Typical High $1,230.27 | Facility | None | $120.23 | $309.03 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $42.66 Median $117.49 Typical High $331.13 | Professional | None | $42.66 | $117.49 | $331.13 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $83.18 Median $158.49 Typical High $295.12 | Professional | None | $83.18 | $158.49 | $295.12 |
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 $33.88 Median $58.88 Typical High $74.13 | Professional | 52 · Reduced service | $33.88 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $18.62 Typical High $30.20 | Professional | 53 · Discontinued | $13.49 | $18.62 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $89.13 Typical High $112.20 | Professional | 54 · Surgery only | $51.29 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $14.13 Typical High $22.39 | Professional | 55 · Aftercare only | $10.23 | $14.13 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $9.33 Typical High $14.79 | Professional | 56 · Pre-op care only | $6.76 | $9.33 | $14.79 |
Where Colorado sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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
$209
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.