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 $85.11 Median $165.96 Typical High $223.87 | Professional | None | $85.11 | $165.96 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $8,912.51 | Facility | None | $2,137.96 | $5,248.07 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $208.93 Typical High $416.87 | Professional | None | $102.33 | $208.93 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,659.59 Typical High $2,691.53 | Facility | None | $436.52 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $181.97 Typical High $316.23 | Professional | None | $89.13 | $181.97 | $316.23 |
Denver HMP Setting Facility Modifier None Typical Low $85.11 Median $186.21 Typical High $295.12 | Facility | None | $85.11 | $186.21 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $223.87 Typical High $398.11 | Professional | None | $102.33 | $223.87 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $436.52 Typical High $2,398.83 | Facility | None | $162.18 | $436.52 | $2,398.83 |
Select Health Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $234.42 | Professional | None | $70.79 | $104.71 | $234.42 |
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 $93.33 Median $177.83 Typical High $316.23 | Professional | None | $93.33 | $177.83 | $316.23 |
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 $42.66 Median $72.44 Typical High $104.71 | Professional | 52 · Reduced service | $42.66 | $72.44 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $28.84 Typical High $43.65 | Professional | 53 · Discontinued | $16.98 | $28.84 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $107.15 Typical High $162.18 | Professional | 54 · Surgery only | $64.57 | $107.15 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $21.38 Typical High $32.36 | Professional | 55 · Aftercare only | $12.88 | $21.38 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $14.45 Typical High $21.38 | Professional | 56 · Pre-op care only | $8.51 | $14.45 | $21.38 |
Where Colorado sits
The same service costs 4.5 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
$209
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.