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 $2,570.40 Median $5,495.41 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $588.84 | Professional | None | $398.11 | $407.38 | $588.84 |
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 $457.09 Median $616.60 Typical High $851.14 | Professional | None | $457.09 | $616.60 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $6,309.57 Typical High $8,709.64 | Facility | None | $1,778.28 | $6,309.57 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $741.31 | Professional | None | $467.74 | $524.81 | $741.31 |
Denver HMP Setting Facility Modifier None Typical Low $407.38 Median $562.34 Typical High $912.01 | Facility | None | $407.38 | $562.34 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $794.33 | Professional | None | $398.11 | $501.19 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $724.44 Typical High $7,585.78 | Facility | None | $363.08 | $724.44 | $7,585.78 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $676.08 | Professional | None | $331.13 | $398.11 | $676.08 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $812.83 | Professional | None | $426.58 | $537.03 | $812.83 |
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 $199.53 Median $204.17 Typical High $239.88 | Professional | 52 · Reduced service | $199.53 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $81.28 Typical High $97.72 | Professional | 53 · Discontinued | $79.43 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $363.08 | Professional | 54 · Surgery only | $302.00 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $72.44 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $40.74 Typical High $47.86 | Professional | 56 · Pre-op care only | $39.81 | $40.74 | $47.86 |
Where Colorado sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 22nd of 51
$575
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.