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 $316.23 Median $3,235.94 Typical High $8,912.51 | Facility | None | $316.23 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $316.23 | Professional | None | $177.83 | $239.88 | $316.23 |
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 $194.98 Median $281.84 Typical High $416.87 | Professional | None | $194.98 | $281.84 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $194.98 Typical High $354.81 | Facility | None | $52.48 | $194.98 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $478.63 | Professional | None | $162.18 | $257.04 | $478.63 |
Denver HMP Setting Facility Modifier None Typical Low $177.83 Median $281.84 Typical High $446.68 | Facility | None | $177.83 | $281.84 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $354.81 Typical High $575.44 | Professional | None | $199.53 | $354.81 | $575.44 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $338.84 Typical High $741.31 | Facility | None | $239.88 | $338.84 | $741.31 |
Select Health Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $354.81 | Professional | None | $173.78 | $218.78 | $354.81 |
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 $177.83 Median $269.15 Typical High $524.81 | Professional | None | $177.83 | $269.15 | $524.81 |
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 $89.13 Median $114.82 Typical High $158.49 | Professional | 52 · Reduced service | $89.13 | $114.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $46.77 Typical High $63.10 | Professional | 53 · Discontinued | $35.48 | $46.77 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $173.78 Typical High $234.42 | Professional | 54 · Surgery only | $131.83 | $173.78 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $34.67 Typical High $46.77 | Professional | 55 · Aftercare only | $26.30 | $34.67 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $23.44 Typical High $31.62 | Professional | 56 · Pre-op care only | $17.78 | $23.44 | $31.62 |
Where Colorado sits
The same service costs 4.0 times more in Alaska than in Maryland. 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· 23rd of 51
$295
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.