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 $2,818.38 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,818.38 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,818.38 Typical High $6,025.60 | Professional | None | $2,754.23 | $2,818.38 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $15,848.93 Median $20,892.96 Typical High $50,118.72 | Facility | None | $15,848.93 | $20,892.96 | $50,118.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $3,548.13 Typical High $5,623.41 | Professional | None | $2,691.53 | $3,548.13 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $5,011.87 | Facility | None | $645.65 | $2,290.87 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $2,884.03 Median $3,630.78 Typical High $5,011.87 | Professional | None | $2,884.03 | $3,630.78 | $5,011.87 |
Denver HMP Setting Facility Modifier None Typical Low $2,818.38 Median $3,090.30 Typical High $5,623.41 | Facility | None | $2,818.38 | $3,090.30 | $5,623.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $3,162.28 Typical High $4,786.30 | Professional | None | $2,137.96 | $3,162.28 | $4,786.30 |
Select Health Setting Facility Modifier None Typical Low $2,238.72 Median $4,570.88 Typical High $4,786.30 | Facility | None | $2,238.72 | $4,570.88 | $4,786.30 |
Select Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,584.89 | $1,584.89 | $2,238.72 |
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 $3,162.28 Median $4,168.69 Typical High $6,309.57 | Professional | None | $3,162.28 | $4,168.69 | $6,309.57 |
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 $1,348.96 Median $1,412.54 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,348.96 | $1,412.54 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $562.34 Typical High $758.58 | Professional | 53 · Discontinued | $549.54 | $562.34 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,089.30 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,041.74 | $2,089.30 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $426.58 Typical High $575.44 | Professional | 55 · Aftercare only | $407.38 | $426.58 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $281.84 Typical High $380.19 | Professional | 56 · Pre-op care only | $275.42 | $281.84 | $380.19 |
Where Colorado sits
The same service costs 5.8 times more in Alaska than in Arkansas. 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· 12th of 51
$4,169
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.