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 $83.18 Median $1,202.26 Typical High $7,585.78 | Facility | None | $83.18 | $1,202.26 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $107.15 Typical High $302.00 | Professional | None | $60.26 | $107.15 | $302.00 |
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 $66.07 Median $93.33 Typical High $134.90 | Professional | None | $66.07 | $93.33 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,698.24 | Facility | None | $50.12 | $66.07 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $263.03 | Professional | None | $70.79 | $114.82 | $263.03 |
Denver HMP Setting Facility Modifier None Typical Low $66.07 Median $123.03 Typical High $269.15 | Facility | None | $66.07 | $123.03 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $125.89 Typical High $288.40 | Professional | None | $53.70 | $125.89 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $97.72 Median $173.78 Typical High $363.08 | Facility | None | $97.72 | $173.78 | $363.08 |
Select Health Setting Professional Modifier None Typical Low $34.67 Median $95.50 Typical High $338.84 | Professional | None | $34.67 | $95.50 | $338.84 |
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 $117.49 Typical High $281.84 | Professional | None | $70.79 | $117.49 | $281.84 |
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 $33.11 Median $50.12 Typical High $93.33 | Professional | 52 · Reduced service | $33.11 | $50.12 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $19.95 Typical High $37.15 | Professional | 53 · Discontinued | $13.18 | $19.95 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $75.86 Typical High $141.25 | Professional | 54 · Surgery only | $48.98 | $75.86 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $15.14 Typical High $28.18 | Professional | 55 · Aftercare only | $9.77 | $15.14 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $10.00 Typical High $18.62 | Professional | 56 · Pre-op care only | $6.61 | $10.00 | $18.62 |
Where Colorado sits
The same service costs 4.0 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· 29th of 51
$129
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.