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 $549.54 Median $3,162.28 Typical High $8,912.51 | Facility | None | $549.54 | $3,162.28 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $1,737.80 Typical High $2,951.21 | Professional | None | $354.81 | $1,737.80 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $1,698.24 Typical High $3,801.89 | Professional | None | $407.38 | $1,698.24 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $1,258.93 Typical High $3,801.89 | Professional | None | $389.05 | $1,258.93 | $3,801.89 |
Denver HMP Setting Facility Modifier None Typical Low $380.19 Median $1,905.46 Typical High $3,235.94 | Facility | None | $380.19 | $1,905.46 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $1,348.96 Typical High $3,981.07 | Professional | None | $371.54 | $1,348.96 | $3,981.07 |
Select Health Setting Facility Modifier None Typical Low $588.84 Median $2,089.30 Typical High $4,365.16 | Facility | None | $588.84 | $2,089.30 | $4,365.16 |
Select Health Setting Professional Modifier None Typical Low $257.04 Median $501.19 Typical High $2,089.30 | Professional | None | $257.04 | $501.19 | $2,089.30 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $2,754.23 | Facility | None | $758.58 | $1,513.56 | $2,754.23 |
United Setting Professional Modifier None Typical Low $380.19 Median $1,548.82 Typical High $3,715.35 | Professional | None | $380.19 | $1,548.82 | $3,715.35 |
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 $190.55 Median $776.25 Typical High $1,071.52 | Professional | 52 · Reduced service | $190.55 | $776.25 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $309.03 Typical High $426.58 | Professional | 53 · Discontinued | $75.86 | $309.03 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $1,174.90 Typical High $1,584.89 | Professional | 54 · Surgery only | $281.84 | $1,174.90 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $234.42 Typical High $323.59 | Professional | 55 · Aftercare only | $56.23 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $154.88 Typical High $213.80 | Professional | 56 · Pre-op care only | $38.02 | $154.88 | $213.80 |
Where Colorado sits
The same service costs 5.5 times more in Washington than in Kentucky. 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· 25th of 51
$1,660
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.