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 $66.07 Median $3,235.94 Typical High $7,762.47 | Facility | None | $66.07 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $81.28 Typical High $158.49 | Professional | None | $41.69 | $81.28 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $120.23 Typical High $245.47 | Professional | None | $50.12 | $120.23 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,698.24 | Facility | None | $50.12 | $66.07 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $85.11 Typical High $177.83 | Professional | None | $42.66 | $85.11 | $177.83 |
Denver HMP Setting Facility Modifier None Typical Low $42.66 Median $104.71 Typical High $169.82 | Facility | None | $42.66 | $104.71 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $51.29 Median $128.82 Typical High $229.09 | Professional | None | $51.29 | $128.82 | $229.09 |
Select Health Setting Facility Modifier None Typical Low $83.18 Median $134.90 Typical High $281.84 | Facility | None | $83.18 | $134.90 | $281.84 |
Select Health Setting Professional Modifier None Typical Low $34.67 Median $53.70 Typical High $134.90 | Professional | None | $34.67 | $53.70 | $134.90 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $43.65 Median $87.10 Typical High $169.82 | Professional | None | $43.65 | $87.10 | $169.82 |
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 $21.38 Median $35.48 Typical High $58.88 | Professional | 52 · Reduced service | $21.38 | $35.48 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $14.13 Typical High $23.99 | Professional | 53 · Discontinued | $8.51 | $14.13 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $53.70 Typical High $89.13 | Professional | 54 · Surgery only | $31.62 | $53.70 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $10.72 Typical High $17.78 | Professional | 55 · Aftercare only | $6.31 | $10.72 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $7.08 Typical High $12.02 | Professional | 56 · Pre-op care only | $4.27 | $7.08 | $12.02 |
Where Colorado sits
The same service costs 3.4 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· 23rd of 51
$102
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.