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 $48.98 Median $109.65 Typical High $147.91 | Professional | None | $48.98 | $109.65 | $147.91 |
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 $58.88 Median $131.83 Typical High $263.03 | Professional | None | $58.88 | $131.83 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $263.03 Typical High $1,659.59 | Facility | None | $151.36 | $263.03 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $109.65 Typical High $199.53 | Professional | None | $54.95 | $109.65 | $199.53 |
Denver HMP Setting Facility Modifier None Typical Low $48.98 Median $112.20 Typical High $190.55 | Facility | None | $48.98 | $112.20 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $147.91 Typical High $263.03 | Professional | None | $56.23 | $147.91 | $263.03 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $181.97 Typical High $323.59 | Facility | None | $91.20 | $181.97 | $323.59 |
Select Health Setting Professional Modifier None Typical Low $40.74 Median $58.88 Typical High $154.88 | Professional | None | $40.74 | $58.88 | $154.88 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,122.02 Typical High $2,884.03 | Facility | None | $489.78 | $1,122.02 | $2,884.03 |
United Setting Professional Modifier None Typical Low $53.70 Median $109.65 Typical High $204.17 | Professional | None | $53.70 | $109.65 | $204.17 |
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 $24.55 Median $48.98 Typical High $67.61 | Professional | 52 · Reduced service | $24.55 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $19.50 Typical High $26.92 | Professional | 53 · Discontinued | $9.77 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $74.13 Typical High $100.00 | Professional | 54 · Surgery only | $37.15 | $74.13 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $14.79 Typical High $19.95 | Professional | 55 · Aftercare only | $7.41 | $14.79 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $9.77 Typical High $13.49 | Professional | 56 · Pre-op care only | $4.90 | $9.77 | $13.49 |
Where Colorado sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 15th of 51
$129
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.