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 $70.79 Median $151.36 Typical High $269.15 | Professional | None | $70.79 | $151.36 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $173.78 | Professional | None | $87.10 | $117.49 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $186.21 Typical High $371.54 | Professional | None | $85.11 | $186.21 | $371.54 |
Denver HMP Setting Facility Modifier None Typical Low $70.79 Median $190.55 Typical High $281.84 | Facility | None | $70.79 | $190.55 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $158.49 Typical High $380.19 | Professional | None | $77.62 | $158.49 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $123.03 Median $194.98 Typical High $407.38 | Facility | None | $123.03 | $194.98 | $407.38 |
Select Health Setting Professional Modifier None Typical Low $56.23 Median $104.71 Typical High $194.98 | Professional | None | $56.23 | $104.71 | $194.98 |
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 $81.28 Median $181.97 Typical High $363.08 | Professional | None | $81.28 | $181.97 | $363.08 |
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 $35.48 Median $74.13 Typical High $100.00 | Professional | 52 · Reduced service | $35.48 | $74.13 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $29.51 Typical High $39.81 | Professional | 53 · Discontinued | $14.13 | $29.51 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $112.20 Typical High $147.91 | Professional | 54 · Surgery only | $53.70 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $22.39 Typical High $30.20 | Professional | 55 · Aftercare only | $10.72 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $14.79 Typical High $19.95 | Professional | 56 · Pre-op care only | $7.08 | $14.79 | $19.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $173.78 Typical High $562.34 | Professional | 50 · Both sides | $107.15 | $173.78 | $562.34 |
Where Colorado sits
The same service costs 3.8 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· 41st of 51
$145
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.