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 $109.65 Median $3,162.28 Typical High $8,912.51 | Facility | None | $109.65 | $3,162.28 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $117.49 Typical High $165.96 | Professional | None | $70.79 | $117.49 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $144.54 Typical High $257.04 | Professional | None | $83.18 | $144.54 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $100.00 Typical High $177.83 | Facility | None | $52.48 | $100.00 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $177.83 | Professional | None | $81.28 | $123.03 | $177.83 |
Denver HMP Setting Facility Modifier None Typical Low $70.79 Median $125.89 Typical High $194.98 | Facility | None | $70.79 | $125.89 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $114.82 Typical High $213.80 | Professional | None | $67.61 | $114.82 | $213.80 |
Select Health Setting Facility Modifier None Typical Low $112.20 Median $125.89 Typical High $263.03 | Facility | None | $112.20 | $125.89 | $263.03 |
Select Health Setting Professional Modifier None Typical Low $39.81 Median $70.79 Typical High $125.89 | Professional | None | $39.81 | $70.79 | $125.89 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $77.62 Median $134.90 Typical High $229.09 | Professional | None | $77.62 | $134.90 | $229.09 |
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 $35.48 Median $57.54 Typical High $63.10 | Professional | 52 · Reduced service | $35.48 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $23.44 Typical High $25.12 | Professional | 53 · Discontinued | $14.13 | $23.44 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $87.10 Typical High $93.33 | Professional | 54 · Surgery only | $52.48 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $17.38 Typical High $19.05 | Professional | 55 · Aftercare only | $10.47 | $17.38 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $11.75 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.08 | $11.75 | $12.59 |
Where Colorado sits
The same service costs 3.3 times more in Alaska than in Maryland. 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
$148
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.