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 $407.38 Median $3,235.94 Typical High $9,120.11 | Facility | None | $407.38 | $3,235.94 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $1,122.02 Typical High $1,995.26 | Professional | None | $263.03 | $1,122.02 | $1,995.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $1,096.48 Typical High $2,630.27 | Professional | None | $295.12 | $1,096.48 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $870.96 Typical High $2,570.40 | Professional | None | $288.40 | $870.96 | $2,570.40 |
Denver HMP Setting Facility Modifier None Typical Low $263.03 Median $1,258.93 Typical High $1,995.26 | Facility | None | $263.03 | $1,258.93 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $851.14 Typical High $2,398.83 | Professional | None | $257.04 | $851.14 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $1,258.93 Typical High $2,630.27 | Facility | None | $407.38 | $1,258.93 | $2,630.27 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $346.74 Typical High $1,258.93 | Professional | None | $177.83 | $346.74 | $1,258.93 |
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 $275.42 Median $1,000.00 Typical High $2,511.89 | Professional | None | $275.42 | $1,000.00 | $2,511.89 |
6 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 $131.83 Median $489.78 Typical High $741.31 | Professional | 52 · Reduced service | $131.83 | $489.78 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $194.98 Typical High $295.12 | Professional | 53 · Discontinued | $52.48 | $194.98 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $724.44 Typical High $1,122.02 | Professional | 54 · Surgery only | $199.53 | $724.44 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $147.91 Typical High $223.87 | Professional | 55 · Aftercare only | $39.81 | $147.91 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $97.72 Typical High $147.91 | Professional | 56 · Pre-op care only | $26.30 | $97.72 | $147.91 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $1,621.81 Typical High $2,137.96 | Professional | 50 · Both sides | $354.81 | $1,621.81 | $2,137.96 |
Where Colorado sits
The same service costs 5.8 times more in Washington than in Hawaii. 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· 20th of 51
$1,148
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.