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 $478.63 Median $549.54 Typical High $3,235.94 | Professional | None | $478.63 | $549.54 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $11,481.54 Typical High $18,620.87 | Facility | None | $7,585.78 | $11,481.54 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,122.02 | Professional | None | $537.03 | $758.58 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,370.32 Typical High $9,772.37 | Facility | None | $758.58 | $5,370.32 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $933.25 | Professional | None | $537.03 | $676.08 | $933.25 |
Denver HMP Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $1,096.48 | Facility | None | $549.54 | $676.08 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $912.01 | Professional | None | $436.52 | $616.60 | $912.01 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $870.96 Typical High $8,511.38 | Facility | None | $436.52 | $870.96 | $8,511.38 |
Select Health Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $851.14 | Professional | None | $309.03 | $436.52 | $851.14 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,096.48 | Professional | None | $549.54 | $691.83 | $1,096.48 |
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 $263.03 Median $269.15 Typical High $288.40 | Professional | 52 · Reduced service | $263.03 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $114.82 | Professional | 53 · Discontinued | $104.71 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $407.38 Typical High $436.52 | Professional | 54 · Surgery only | $398.11 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $79.43 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $54.95 Typical High $57.54 | Professional | 56 · Pre-op care only | $52.48 | $54.95 | $57.54 |
Where Colorado sits
The same service costs 3.9 times more in Alaska 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· 13th of 51
$933
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.