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 $91.20 Median $186.21 Typical High $229.09 | Professional | None | $91.20 | $186.21 | $229.09 |
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 $109.65 Median $223.87 Typical High $426.58 | Professional | None | $109.65 | $223.87 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $954.99 Typical High $1,659.59 | Facility | None | $436.52 | $954.99 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $204.17 Typical High $323.59 | Professional | None | $102.33 | $204.17 | $323.59 |
Denver HMP Setting Facility Modifier None Typical Low $91.20 Median $213.80 Typical High $309.03 | Facility | None | $91.20 | $213.80 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $229.09 Typical High $416.87 | Professional | None | $107.15 | $229.09 | $416.87 |
Select Health Setting Facility Modifier None Typical Low $169.82 Median $446.68 Typical High $1,096.48 | Facility | None | $169.82 | $446.68 | $1,096.48 |
Select Health Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $245.47 | Professional | None | $74.13 | $112.20 | $245.47 |
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 $104.71 Median $190.55 Typical High $338.84 | Professional | None | $104.71 | $190.55 | $338.84 |
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 $45.71 Median $77.62 Typical High $109.65 | Professional | 52 · Reduced service | $45.71 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $30.90 Typical High $43.65 | Professional | 53 · Discontinued | $18.20 | $30.90 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $114.82 Typical High $165.96 | Professional | 54 · Surgery only | $67.61 | $114.82 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $22.91 Typical High $33.11 | Professional | 55 · Aftercare only | $13.49 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $15.49 Typical High $21.88 | Professional | 56 · Pre-op care only | $9.12 | $15.49 | $21.88 |
Where Colorado sits
The same service costs 4.2 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· 21st of 51
$214
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.