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 $104.71 Median $3,235.94 Typical High $8,912.51 | Facility | None | $104.71 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $91.20 Typical High $104.71 | Professional | None | $70.79 | $91.20 | $104.71 |
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 $77.62 Median $112.20 Typical High $169.82 | Professional | None | $77.62 | $112.20 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $100.00 Typical High $181.97 | Facility | None | $52.48 | $100.00 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $162.18 | Professional | None | $66.07 | $100.00 | $162.18 |
Denver HMP Setting Facility Modifier None Typical Low $70.79 Median $104.71 Typical High $169.82 | Facility | None | $70.79 | $104.71 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $128.82 Typical High $194.98 | Professional | None | $81.28 | $128.82 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $131.83 Typical High $245.47 | Facility | None | $117.49 | $131.83 | $245.47 |
Select Health Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $117.49 | Professional | None | $70.79 | $89.13 | $117.49 |
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 $70.79 Median $102.33 Typical High $181.97 | Professional | None | $70.79 | $102.33 | $181.97 |
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 $35.48 Median $44.67 Typical High $52.48 | Professional | 52 · Reduced service | $35.48 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $17.78 Typical High $20.89 | Professional | 53 · Discontinued | $14.13 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $67.61 Typical High $79.43 | Professional | 54 · Surgery only | $53.70 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.49 Typical High $15.85 | Professional | 55 · Aftercare only | $10.72 | $13.49 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.08 | $8.91 | $10.47 |
Where Colorado sits
The same service costs 3.8 times more in Alaska than in Florida. 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· 20th of 51
$112
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.