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 $81.28 Median $3,235.94 Typical High $8,912.51 | Facility | None | $81.28 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $75.86 Typical High $81.28 | Professional | None | $50.12 | $75.86 | $81.28 |
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 $57.54 Median $81.28 Typical High $120.23 | Professional | None | $57.54 | $81.28 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $83.18 Typical High $141.25 | Facility | None | $52.48 | $83.18 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $125.89 | Professional | None | $51.29 | $75.86 | $125.89 |
Denver HMP Setting Facility Modifier None Typical Low $50.12 Median $81.28 Typical High $117.49 | Facility | None | $50.12 | $81.28 | $117.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $57.54 Median $91.20 Typical High $147.91 | Professional | None | $57.54 | $91.20 | $147.91 |
Select Health Setting Facility Modifier None Typical Low $87.10 Median $95.50 Typical High $181.97 | Facility | None | $87.10 | $95.50 | $181.97 |
Select Health Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $87.10 | Professional | None | $50.12 | $61.66 | $87.10 |
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 $53.70 Median $81.28 Typical High $144.54 | Professional | None | $53.70 | $81.28 | $144.54 |
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 $25.12 Median $33.88 Typical High $40.74 | Professional | 52 · Reduced service | $25.12 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $13.80 Typical High $16.22 | Professional | 53 · Discontinued | $10.00 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $51.29 Typical High $61.66 | Professional | 54 · Surgery only | $38.02 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $10.23 Typical High $12.30 | Professional | 55 · Aftercare only | $7.59 | $10.23 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $6.92 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.01 | $6.92 | $8.13 |
Where Colorado sits
The same service costs 3.6 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· 26th of 51
$83.18
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.