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 $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $5,495.41 | Professional | None | $181.97 | $181.97 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $457.09 | Professional | None | $223.87 | $309.03 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $6,760.83 | Facility | None | $1,479.11 | $3,467.37 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $389.05 | Professional | None | $213.80 | $281.84 | $389.05 |
Denver HMP Setting Facility Modifier None Typical Low $181.97 Median $229.09 Typical High $316.23 | Facility | None | $181.97 | $229.09 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $331.13 | Professional | None | $158.49 | $223.87 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $158.49 Median $316.23 Typical High $3,981.07 | Facility | None | $158.49 | $316.23 | $3,981.07 |
Select Health Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $309.03 | Professional | None | $109.65 | $158.49 | $309.03 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $457.09 | Professional | None | $229.09 | $288.40 | $457.09 |
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 $91.20 Median $91.20 Typical High $107.15 | Professional | 52 · Reduced service | $91.20 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $42.66 | Professional | 53 · Discontinued | $36.31 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | 54 · Surgery only | $134.90 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $32.36 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $21.38 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $21.38 |
Where Colorado sits
The same service costs 10.2 times more in Oklahoma than in Kentucky. 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· 16th of 51
$389
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.