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 $1,479.11 Median $3,715.35 Typical High $10,715.19 | Facility | None | $1,479.11 | $3,715.35 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $1,445.44 Typical High $5,495.41 | Professional | None | $380.19 | $1,445.44 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $1,174.90 Typical High $2,630.27 | Professional | None | $398.11 | $1,174.90 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,090.30 Typical High $4,168.69 | Facility | None | $758.58 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $1,071.52 Typical High $2,454.71 | Professional | None | $457.09 | $1,071.52 | $2,454.71 |
Denver HMP Setting Facility Modifier None Typical Low $380.19 Median $1,047.13 Typical High $2,344.23 | Facility | None | $380.19 | $1,047.13 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $812.83 Typical High $2,238.72 | Professional | None | $316.23 | $812.83 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $2,290.87 Typical High $3,630.78 | Facility | None | $602.56 | $2,290.87 | $3,630.78 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $1,230.27 | Professional | None | $213.80 | $213.80 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $501.19 Median $1,548.82 Typical High $3,019.95 | Professional | None | $501.19 | $1,548.82 | $3,019.95 |
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 $190.55 Median $588.84 Typical High $724.44 | Professional | 52 · Reduced service | $190.55 | $588.84 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $234.42 Typical High $295.12 | Professional | 53 · Discontinued | $75.86 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $891.25 Typical High $1,096.48 | Professional | 54 · Surgery only | $281.84 | $891.25 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $177.83 Typical High $218.78 | Professional | 55 · Aftercare only | $56.23 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $117.49 Typical High $147.91 | Professional | 56 · Pre-op care only | $38.02 | $117.49 | $147.91 |
Where Colorado sits
The same service costs 5.1 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· 9th of 51
$1,995
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.