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 $162.18 Median $239.88 Typical High $263.03 | Professional | None | $162.18 | $239.88 | $263.03 |
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 $181.97 Median $257.04 Typical High $389.05 | Professional | None | $181.97 | $257.04 | $389.05 |
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 $165.96 Median $245.47 Typical High $407.38 | Professional | None | $165.96 | $245.47 | $407.38 |
Denver HMP Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $389.05 | Facility | None | $162.18 | $263.03 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $478.63 | Professional | None | $186.21 | $309.03 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $295.12 Typical High $616.60 | Facility | None | $239.88 | $295.12 | $616.60 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $295.12 | Professional | None | $158.49 | $199.53 | $295.12 |
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 $173.78 Median $263.03 Typical High $457.09 | Professional | None | $173.78 | $263.03 | $457.09 |
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 $81.28 Median $109.65 Typical High $131.83 | Professional | 52 · Reduced service | $81.28 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $43.65 Typical High $52.48 | Professional | 53 · Discontinued | $32.36 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $165.96 Typical High $199.53 | Professional | 54 · Surgery only | $120.23 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.11 Typical High $39.81 | Professional | 55 · Aftercare only | $23.99 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $21.88 Typical High $26.30 | Professional | 56 · Pre-op care only | $16.22 | $21.88 | $26.30 |
Where Colorado sits
The same service costs 3.9 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· 22nd of 51
$263
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.