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 $128.82 Median $141.25 Typical High $169.82 | Professional | None | $128.82 | $141.25 | $169.82 |
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 $138.04 Median $181.97 Typical High $257.04 | Professional | None | $138.04 | $181.97 | $257.04 |
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 $141.25 Median $158.49 Typical High $229.09 | Professional | None | $141.25 | $158.49 | $229.09 |
Denver HMP Setting Facility Modifier None Typical Low $141.25 Median $165.96 Typical High $281.84 | Facility | None | $141.25 | $165.96 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $245.47 | Professional | None | $128.82 | $154.88 | $245.47 |
Select Health Setting Facility Modifier None Typical Low $112.20 Median $223.87 Typical High $407.38 | Facility | None | $112.20 | $223.87 | $407.38 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $186.21 | Professional | None | $100.00 | $117.49 | $186.21 |
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 $125.89 Median $162.18 Typical High $251.19 | Professional | None | $125.89 | $162.18 | $251.19 |
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 $64.57 Median $69.18 Typical High $77.62 | Professional | 52 · Reduced service | $64.57 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $28.18 Typical High $31.62 | Professional | 53 · Discontinued | $25.70 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $104.71 Typical High $117.49 | Professional | 54 · Surgery only | $95.50 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $20.89 Typical High $23.44 | Professional | 55 · Aftercare only | $19.05 | $20.89 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $14.13 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.88 | $14.13 | $15.85 |
Where Colorado sits
The same service costs 5.1 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· 22nd of 51
$178
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.