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 $3,981.07 Typical High $8,912.51 | Facility | None | $1,148.15 | $3,981.07 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $134.90 Typical High $6,025.60 | Professional | None | $128.82 | $134.90 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,762.47 Typical High $13,182.57 | Facility | None | $6,165.95 | $7,762.47 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $269.15 | Professional | None | $128.82 | $169.82 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,995.26 Typical High $3,890.45 | Facility | None | $436.52 | $1,995.26 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $234.42 | Professional | None | $134.90 | $173.78 | $234.42 |
Denver HMP Setting Facility Modifier None Typical Low $134.90 Median $169.82 Typical High $257.04 | Facility | None | $134.90 | $169.82 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $229.09 | Professional | None | $97.72 | $144.54 | $229.09 |
Select Health Setting Facility Modifier None Typical Low $102.33 Median $204.17 Typical High $3,388.44 | Facility | None | $102.33 | $204.17 | $3,388.44 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $102.33 | Professional | None | $72.44 | $72.44 | $102.33 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,748.98 | Facility | None | $1,479.11 | $3,548.13 | $11,748.98 |
United Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $281.84 | Professional | None | $138.04 | $181.97 | $281.84 |
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 $64.57 Median $67.61 Typical High $89.13 | Professional | 52 · Reduced service | $64.57 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.92 Typical High $35.48 | Professional | 53 · Discontinued | $25.70 | $26.92 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $102.33 Typical High $131.83 | Professional | 54 · Surgery only | $97.72 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $20.42 Typical High $26.30 | Professional | 55 · Aftercare only | $19.50 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.88 | $13.49 | $17.78 |
Where Colorado sits
The same service costs 12.9 times more in Arkansas than in New York. 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· 3rd of 51
$1,445
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.