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 $79.43 Median $2,570.40 Typical High $7,585.78 | Facility | None | $79.43 | $2,570.40 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $97.72 Typical High $154.88 | Professional | None | $57.54 | $97.72 | $154.88 |
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 $74.13 Median $123.03 Typical High $213.80 | Professional | None | $74.13 | $123.03 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $91.20 Typical High $831.76 | Facility | None | $63.10 | $91.20 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $158.49 | Professional | None | $70.79 | $104.71 | $158.49 |
Denver HMP Setting Facility Modifier None Typical Low $57.54 Median $100.00 Typical High $154.88 | Facility | None | $57.54 | $100.00 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $107.15 Typical High $181.97 | Professional | None | $60.26 | $107.15 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $107.15 Typical High $223.87 | Facility | None | $100.00 | $107.15 | $223.87 |
Select Health Setting Professional Modifier None Typical Low $57.54 Median $64.57 Typical High $107.15 | Professional | None | $57.54 | $64.57 | $107.15 |
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 $69.18 Median $104.71 Typical High $173.78 | Professional | None | $69.18 | $104.71 | $173.78 |
6 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 $28.84 Median $41.69 Typical High $50.12 | Professional | 52 · Reduced service | $28.84 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $16.60 Typical High $19.95 | Professional | 53 · Discontinued | $11.75 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $63.10 Typical High $74.13 | Professional | 54 · Surgery only | $43.65 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.59 Typical High $14.79 | Professional | 55 · Aftercare only | $8.71 | $12.59 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.32 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.75 | $8.32 | $10.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $72.44 Median $120.23 Typical High $186.21 | Professional | 50 · Both sides | $72.44 | $120.23 | $186.21 |
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· 17th of 51
$117
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.