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 $1,778.28 Median $6,025.60 Typical High $12,302.69 | Facility | None | $1,778.28 | $6,025.60 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $6,456.54 | Professional | None | $151.36 | $151.36 | $6,456.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $9,549.93 Typical High $17,378.01 | Facility | None | $7,585.78 | $9,549.93 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $302.00 | Professional | None | $144.54 | $190.55 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,801.89 Typical High $6,025.60 | Facility | None | $691.83 | $3,801.89 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $275.42 | Professional | None | $169.82 | $204.17 | $275.42 |
Denver HMP Setting Facility Modifier None Typical Low $151.36 Median $194.98 Typical High $302.00 | Facility | None | $151.36 | $194.98 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $251.19 | Professional | None | $114.82 | $169.82 | $251.19 |
Select Health Setting Facility Modifier None Typical Low $120.23 Median $239.88 Typical High $5,248.07 | Facility | None | $120.23 | $239.88 | $5,248.07 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $120.23 | Professional | None | $85.11 | $85.11 | $120.23 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,848.93 | Facility | None | $2,511.89 | $6,025.60 | $15,848.93 |
United Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $338.84 | Professional | None | $173.78 | $218.78 | $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 $72.44 Median $75.86 Typical High $100.00 | Professional | 52 · Reduced service | $72.44 | $75.86 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $30.20 Typical High $39.81 | Professional | 53 · Discontinued | $28.84 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $112.20 Typical High $151.36 | Professional | 54 · Surgery only | $109.65 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $22.39 Typical High $30.20 | Professional | 55 · Aftercare only | $21.88 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.14 Typical High $19.95 | Professional | 56 · Pre-op care only | $14.45 | $15.14 | $19.95 |
Where Colorado sits
The same service costs 17.8 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· 2nd of 51
$2,512
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.