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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $177.83 Typical High $218.78 | Professional | None | $81.28 | $177.83 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $3,311.31 Typical High $5,370.32 | Facility | None | $1,778.28 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $204.17 Typical High $389.05 | Professional | None | $100.00 | $204.17 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $309.03 Typical High $2,691.53 | Facility | None | $177.83 | $309.03 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $194.98 Typical High $302.00 | Professional | None | $95.50 | $194.98 | $302.00 |
Denver HMP Setting Facility Modifier None Typical Low $81.28 Median $177.83 Typical High $338.84 | Facility | None | $81.28 | $177.83 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $194.98 Typical High $346.74 | Professional | None | $85.11 | $194.98 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $138.04 Median $218.78 Typical High $426.58 | Facility | None | $138.04 | $218.78 | $426.58 |
Select Health Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $204.17 | Professional | None | $67.61 | $89.13 | $204.17 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $4,897.79 | Facility | None | $676.08 | $1,412.54 | $4,897.79 |
United Setting Professional Modifier None Typical Low $95.50 Median $181.97 Typical High $323.59 | Professional | None | $95.50 | $181.97 | $323.59 |
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 $40.74 Median $81.28 Typical High $100.00 | Professional | 52 · Reduced service | $40.74 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $33.11 Typical High $39.81 | Professional | 53 · Discontinued | $16.22 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $123.03 Typical High $147.91 | Professional | 54 · Surgery only | $61.66 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $24.55 Typical High $30.20 | Professional | 55 · Aftercare only | $12.30 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $16.22 Typical High $19.95 | Professional | 56 · Pre-op care only | $8.13 | $16.22 | $19.95 |
Where Colorado sits
The same service costs 3.7 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· 19th of 51
$200
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.