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 $2,570.40 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $5,495.41 | Professional | None | $1,071.52 | $1,737.80 | $5,495.41 |
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 $1,698.24 Median $2,238.72 Typical High $3,548.13 | Professional | None | $1,698.24 | $2,238.72 | $3,548.13 |
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 $1,862.09 Median $2,238.72 Typical High $3,019.95 | Professional | None | $1,862.09 | $2,238.72 | $3,019.95 |
Denver HMP Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $4,786.30 | Facility | None | $1,737.80 | $1,737.80 | $4,786.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,344.23 Median $3,467.37 Typical High $5,128.61 | Professional | None | $2,344.23 | $3,467.37 | $5,128.61 |
Select Health Setting Facility Modifier None Typical Low $2,454.71 Median $4,897.79 Typical High $5,128.61 | Facility | None | $2,454.71 | $4,897.79 | $5,128.61 |
Select Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,737.80 | $1,737.80 | $2,454.71 |
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 $1,862.09 Median $2,344.23 Typical High $3,467.37 | Professional | None | $1,862.09 | $2,344.23 | $3,467.37 |
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 $831.76 Median $870.96 Typical High $1,122.02 | Professional | 52 · Reduced service | $831.76 | $870.96 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $346.74 Typical High $446.68 | Professional | 53 · Discontinued | $331.13 | $346.74 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,318.26 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,258.93 | $1,318.26 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $263.03 Typical High $338.84 | Professional | 55 · Aftercare only | $251.19 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $173.78 Typical High $223.87 | Professional | 56 · Pre-op care only | $165.96 | $173.78 | $223.87 |
Where Colorado sits
The same service costs 4.7 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· 6th of 51
$2,951
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.