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 $218.78 Median $3,311.31 Typical High $8,912.51 | Facility | None | $218.78 | $3,311.31 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $208.93 Typical High $380.19 | Professional | None | $95.50 | $208.93 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,365.16 Median $5,754.40 Typical High $10,471.29 | Facility | None | $4,365.16 | $5,754.40 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $204.17 Typical High $398.11 | Professional | None | $100.00 | $204.17 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $2,238.72 Typical High $3,090.30 | Facility | None | $436.52 | $2,238.72 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $234.42 Typical High $371.54 | Professional | None | $123.03 | $234.42 | $371.54 |
Denver HMP Setting Facility Modifier None Typical Low $95.50 Median $218.78 Typical High $436.52 | Facility | None | $95.50 | $218.78 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $165.96 Typical High $380.19 | Professional | None | $83.18 | $165.96 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $158.49 Median $407.38 Typical High $2,691.53 | Facility | None | $158.49 | $407.38 | $2,691.53 |
Select Health Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $223.87 | Professional | None | $56.23 | $56.23 | $223.87 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,174.90 Typical High $3,388.44 | Facility | None | $489.78 | $1,174.90 | $3,388.44 |
United Setting Professional Modifier None Typical Low $134.90 Median $251.19 Typical High $436.52 | Professional | None | $134.90 | $251.19 | $436.52 |
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 $47.86 Median $91.20 Typical High $107.15 | Professional | 52 · Reduced service | $47.86 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $36.31 Typical High $43.65 | Professional | 53 · Discontinued | $19.05 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $134.90 Typical High $162.18 | Professional | 54 · Surgery only | $70.79 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $26.92 Typical High $32.36 | Professional | 55 · Aftercare only | $14.45 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $18.20 Typical High $21.88 | Professional | 56 · Pre-op care only | $9.55 | $18.20 | $21.88 |
Where Colorado sits
The same service costs 4.1 times more in Alaska than in Nebraska. 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· 17th of 51
$324
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.