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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $6,025.60 | Professional | None | $229.09 | $229.09 | $6,025.60 |
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 $229.09 Median $323.59 Typical High $467.74 | Professional | None | $229.09 | $323.59 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $4,897.79 Typical High $6,760.83 | Facility | None | $1,023.29 | $4,897.79 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $309.03 Typical High $407.38 | Professional | None | $251.19 | $309.03 | $407.38 |
Denver HMP Setting Facility Modifier None Typical Low $229.09 Median $245.47 Typical High $446.68 | Facility | None | $229.09 | $245.47 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $398.11 | Professional | None | $177.83 | $251.19 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $177.83 Median $363.08 Typical High $5,754.40 | Facility | None | $177.83 | $363.08 | $5,754.40 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $346.74 | Professional | None | $125.89 | $177.83 | $346.74 |
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 $239.88 Median $338.84 Typical High $467.74 | Professional | None | $239.88 | $338.84 | $467.74 |
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 $112.20 Median $114.82 Typical High $128.82 | Professional | 52 · Reduced service | $112.20 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $51.29 | Professional | 53 · Discontinued | $45.71 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $173.78 Typical High $190.55 | Professional | 54 · Surgery only | $169.82 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $34.67 Typical High $38.02 | Professional | 55 · Aftercare only | $33.88 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.91 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.39 | $22.91 | $25.70 |
Where Colorado sits
The same service costs 6.9 times more in Tennessee than in New York. 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· 17th of 51
$398
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.