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 $1,995.26 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $3,235.94 Typical High $5,248.07 | Professional | None | $281.84 | $3,235.94 | $5,248.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,715.19 Median $13,182.57 Typical High $24,547.09 | Facility | None | $10,715.19 | $13,182.57 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $2,511.89 Typical High $6,760.83 | Professional | None | $323.59 | $2,511.89 | $6,760.83 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,548.13 Typical High $6,760.83 | Facility | None | $831.76 | $3,548.13 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $616.60 Typical High $6,025.60 | Professional | None | $309.03 | $616.60 | $6,025.60 |
Denver HMP Setting Facility Modifier None Typical Low $302.00 Median $602.56 Typical High $5,128.61 | Facility | None | $302.00 | $602.56 | $5,128.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $1,000.00 Typical High $5,370.32 | Professional | None | $239.88 | $1,000.00 | $5,370.32 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $3,801.89 Typical High $6,606.93 | Facility | None | $436.52 | $3,801.89 | $6,606.93 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $416.87 Typical High $6,165.95 | Professional | None | $151.36 | $416.87 | $6,165.95 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $316.23 Median $2,187.76 Typical High $6,606.93 | Professional | None | $316.23 | $2,187.76 | $6,606.93 |
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 $147.91 Median $1,348.96 Typical High $1,778.28 | Professional | 52 · Reduced service | $147.91 | $1,348.96 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $537.03 Typical High $724.44 | Professional | 53 · Discontinued | $60.26 | $537.03 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $1,995.26 Typical High $2,691.53 | Professional | 54 · Surgery only | $223.87 | $1,995.26 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $398.11 Typical High $537.03 | Professional | 55 · Aftercare only | $44.67 | $398.11 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $269.15 Typical High $363.08 | Professional | 56 · Pre-op care only | $30.20 | $269.15 | $363.08 |
Where Colorado sits
The same service costs 10.2 times more in Alaska than in Nebraska. 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· 8th of 51
$3,890
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.