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 $1,148.15 Median $3,388.44 Typical High $8,709.64 | Facility | None | $1,148.15 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $5,495.41 | Professional | None | $89.13 | $91.20 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $5,248.07 Typical High $8,912.51 | Facility | None | $3,467.37 | $5,248.07 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $186.21 | Professional | None | $89.13 | $125.89 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $177.83 | Professional | None | $97.72 | $117.49 | $177.83 |
Denver HMP Setting Facility Modifier None Typical Low $91.20 Median $123.03 Typical High $177.83 | Facility | None | $91.20 | $123.03 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $147.91 | Professional | None | $70.79 | $100.00 | $147.91 |
Select Health Setting Facility Modifier None Typical Low $70.79 Median $141.25 Typical High $147.91 | Facility | None | $70.79 | $141.25 | $147.91 |
Select Health Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $138.04 | Professional | None | $48.98 | $70.79 | $138.04 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $181.97 | Professional | None | $95.50 | $123.03 | $181.97 |
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 $44.67 Median $45.71 Typical High $48.98 | Professional | 52 · Reduced service | $44.67 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $18.20 Typical High $19.50 | Professional | 53 · Discontinued | $17.78 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $67.61 Typical High $72.44 | Professional | 54 · Surgery only | $66.07 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.49 Typical High $14.79 | Professional | 55 · Aftercare only | $13.18 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.12 Typical High $9.77 | Professional | 56 · Pre-op care only | $8.91 | $9.12 | $9.77 |
Where Colorado sits
The same service costs 6.5 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· 14th of 51
$158
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.