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 $954.99 Median $3,388.44 Typical High $8,912.51 | Facility | None | $954.99 | $3,388.44 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $436.52 Typical High $676.08 | Professional | None | $91.20 | $436.52 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,290.87 Median $3,548.13 Typical High $9,120.11 | Facility | None | $2,290.87 | $3,548.13 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $363.08 Typical High $776.25 | Professional | None | $95.50 | $363.08 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $660.69 Typical High $2,691.53 | Facility | None | $436.52 | $660.69 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $371.54 Typical High $707.95 | Professional | None | $114.82 | $371.54 | $707.95 |
Denver HMP Setting Facility Modifier None Typical Low $91.20 Median $263.03 Typical High $616.60 | Facility | None | $91.20 | $263.03 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $251.19 Typical High $660.69 | Professional | None | $75.86 | $251.19 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $537.03 Typical High $812.83 | Facility | None | $144.54 | $537.03 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $380.19 | Professional | None | $51.29 | $51.29 | $380.19 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,202.26 Typical High $3,311.31 | Facility | None | $489.78 | $1,202.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $123.03 Median $407.38 Typical High $776.25 | Professional | None | $123.03 | $407.38 | $776.25 |
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 $45.71 Median $173.78 Typical High $234.42 | Professional | 52 · Reduced service | $45.71 | $173.78 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $69.18 Typical High $93.33 | Professional | 53 · Discontinued | $18.20 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $263.03 Typical High $346.74 | Professional | 54 · Surgery only | $69.18 | $263.03 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $52.48 Typical High $69.18 | Professional | 55 · Aftercare only | $13.80 | $52.48 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $34.67 Typical High $46.77 | Professional | 56 · Pre-op care only | $9.12 | $34.67 | $46.77 |
Where Colorado sits
The same service costs 7.8 times more in Oklahoma 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· 6th of 51
$575
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.