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 $120.23 Median $123.03 Typical High $173.78 | Professional | None | $120.23 | $123.03 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $251.19 | Professional | None | $138.04 | $186.21 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,047.13 Typical High $2,691.53 | Facility | None | $676.08 | $1,047.13 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $223.87 | Professional | None | $125.89 | $151.36 | $223.87 |
Denver HMP Setting Facility Modifier None Typical Low $123.03 Median $158.49 Typical High $186.21 | Facility | None | $123.03 | $158.49 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $346.74 Typical High $512.86 | Professional | None | $154.88 | $346.74 | $512.86 |
Select Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,096.48 | Facility | None | $1,023.29 | $1,023.29 | $1,096.48 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $1,000.00 | Professional | None | $831.76 | $870.96 | $1,000.00 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $245.47 | Professional | None | $125.89 | $154.88 | $245.47 |
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 $60.26 Median $61.66 Typical High $72.44 | Professional | 52 · Reduced service | $60.26 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $24.55 Typical High $28.84 | Professional | 53 · Discontinued | $23.99 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $93.33 Typical High $109.65 | Professional | 54 · Surgery only | $89.13 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $18.62 Typical High $21.88 | Professional | 55 · Aftercare only | $17.78 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.30 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.02 | $12.30 | $14.45 |
Where Colorado sits
The same service costs 6.0 times more in Alaska 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· 17th of 51
$178
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.