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 $45.71 Median $3,090.30 Typical High $7,762.47 | Facility | None | $45.71 | $3,090.30 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $52.48 Typical High $81.28 | Professional | None | $36.31 | $52.48 | $81.28 |
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 $45.71 Median $72.44 Typical High $120.23 | Professional | None | $45.71 | $72.44 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $61.66 Typical High $1,659.59 | Facility | None | $35.48 | $61.66 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $57.54 Typical High $89.13 | Professional | None | $39.81 | $57.54 | $89.13 |
Denver HMP Setting Facility Modifier None Typical Low $36.31 Median $53.70 Typical High $83.18 | Facility | None | $36.31 | $53.70 | $83.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $91.20 | Professional | None | $43.65 | $63.10 | $91.20 |
Select Health Setting Facility Modifier None Typical Low $43.65 Median $53.70 Typical High $112.20 | Facility | None | $43.65 | $53.70 | $112.20 |
Select Health Setting Professional Modifier None Typical Low $35.48 Median $46.77 Typical High $54.95 | Professional | None | $35.48 | $46.77 | $54.95 |
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 $60.26 Typical High $102.33 | Professional | None | $40.74 | $60.26 | $102.33 |
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 $18.20 Median $24.55 Typical High $26.30 | Professional | 52 · Reduced service | $18.20 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $10.00 Typical High $10.47 | Professional | 53 · Discontinued | $7.24 | $10.00 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $37.15 Typical High $39.81 | Professional | 54 · Surgery only | $26.92 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $7.41 Typical High $7.94 | Professional | 55 · Aftercare only | $5.37 | $7.41 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.90 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.63 | $4.90 | $5.25 |
Where Colorado sits
The same service costs 4.2 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· 18th of 51
$67.61
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.