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 $3,388.44 Typical High $8,709.64 | Facility | None | $1,148.15 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $208.93 | Professional | None | $125.89 | $125.89 | $208.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $309.03 | Professional | None | $151.36 | $208.93 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $331.13 | Professional | None | $138.04 | $190.55 | $331.13 |
Denver HMP Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $218.78 | Facility | None | $125.89 | $162.18 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $239.88 | Professional | None | $114.82 | $165.96 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $109.65 Median $204.17 Typical High $229.09 | Facility | None | $109.65 | $204.17 | $229.09 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $213.80 | Professional | None | $100.00 | $134.90 | $213.80 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $2,754.23 | Facility | None | $758.58 | $1,513.56 | $2,754.23 |
United Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $302.00 | Professional | None | $131.83 | $190.55 | $302.00 |
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 $63.10 Median $63.10 Typical High $77.62 | Professional | 52 · Reduced service | $63.10 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $30.90 | Professional | 53 · Discontinued | $25.12 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $114.82 | Professional | 54 · Surgery only | $93.33 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $23.44 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $15.49 |
Where Colorado sits
The same service costs 3.7 times more in Alaska 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· 21st of 51
$195
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.