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 $66.07 Median $1,202.26 Typical High $7,585.78 | Facility | None | $66.07 | $1,202.26 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $134.90 Typical High $239.88 | Professional | None | $48.98 | $134.90 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $81.28 Typical High $120.23 | Professional | None | $60.26 | $81.28 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $151.36 Typical High $316.23 | Professional | None | $57.54 | $151.36 | $316.23 |
Denver HMP Setting Facility Modifier None Typical Low $48.98 Median $158.49 Typical High $234.42 | Facility | None | $48.98 | $158.49 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $52.48 Median $123.03 Typical High $323.59 | Professional | None | $52.48 | $123.03 | $323.59 |
Select Health Setting Facility Modifier None Typical Low $85.11 Median $165.96 Typical High $346.74 | Facility | None | $85.11 | $165.96 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $38.90 Median $72.44 Typical High $165.96 | Professional | None | $38.90 | $72.44 | $165.96 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $2,754.23 | Facility | None | $758.58 | $1,513.56 | $2,754.23 |
United Setting Professional Modifier None Typical Low $56.23 Median $144.54 Typical High $302.00 | Professional | None | $56.23 | $144.54 | $302.00 |
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 $24.55 Median $54.95 Typical High $83.18 | Professional | 52 · Reduced service | $24.55 | $54.95 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $21.88 Typical High $33.88 | Professional | 53 · Discontinued | $9.77 | $21.88 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $83.18 Typical High $125.89 | Professional | 54 · Surgery only | $36.31 | $83.18 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $16.60 Typical High $25.12 | Professional | 55 · Aftercare only | $7.24 | $16.60 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $10.96 Typical High $16.98 | Professional | 56 · Pre-op care only | $4.90 | $10.96 | $16.98 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $74.13 Median $144.54 Typical High $251.19 | Professional | 50 · Both sides | $74.13 | $144.54 | $251.19 |
Where Colorado sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 45th of 51
$100
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.