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 $1,148.15 Median $3,388.44 Typical High $8,709.64 | Facility | None | $1,148.15 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $229.09 | Professional | None | $169.82 | $190.55 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $354.81 | Professional | None | $186.21 | $245.47 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $446.68 Typical High $1,659.59 | Facility | None | $309.03 | $446.68 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $295.12 | Professional | None | $128.82 | $181.97 | $295.12 |
Denver HMP Setting Facility Modifier None Typical Low $147.91 Median $190.55 Typical High $363.08 | Facility | None | $147.91 | $190.55 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $316.23 | Professional | None | $162.18 | $204.17 | $316.23 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $288.40 Typical High $407.38 | Facility | None | $144.54 | $288.40 | $407.38 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $257.04 | Professional | None | $138.04 | $162.18 | $257.04 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $338.84 | Professional | None | $131.83 | $204.17 | $338.84 |
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 $85.11 Median $95.50 Typical High $107.15 | Professional | 52 · Reduced service | $85.11 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $38.90 Typical High $43.65 | Professional | 53 · Discontinued | $33.88 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $144.54 Typical High $162.18 | Professional | 54 · Surgery only | $125.89 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $28.84 Typical High $32.36 | Professional | 55 · Aftercare only | $25.70 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.05 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.98 | $19.05 | $21.88 |
Where Colorado sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 18th of 51
$234
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.