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 $66.07 Median $123.03 Typical High $186.21 | Professional | None | $66.07 | $123.03 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $173.78 Typical High $346.74 | Professional | None | $79.43 | $173.78 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $323.59 Typical High $2,691.53 | Facility | None | $186.21 | $323.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $131.83 Typical High $257.04 | Professional | None | $74.13 | $131.83 | $257.04 |
Denver HMP Setting Facility Modifier None Typical Low $66.07 Median $165.96 Typical High $245.47 | Facility | None | $66.07 | $165.96 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $181.97 Typical High $323.59 | Professional | None | $77.62 | $181.97 | $323.59 |
Select Health Setting Facility Modifier None Typical Low $123.03 Median $223.87 Typical High $407.38 | Facility | None | $123.03 | $223.87 | $407.38 |
Select Health Setting Professional Modifier None Typical Low $53.70 Median $81.28 Typical High $190.55 | Professional | None | $53.70 | $81.28 | $190.55 |
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 $74.13 Median $134.90 Typical High $245.47 | Professional | None | $74.13 | $134.90 | $245.47 |
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 $33.11 Median $53.70 Typical High $85.11 | Professional | 52 · Reduced service | $33.11 | $53.70 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $21.38 Typical High $33.88 | Professional | 53 · Discontinued | $13.18 | $21.38 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $81.28 Typical High $128.82 | Professional | 54 · Surgery only | $48.98 | $81.28 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $16.22 Typical High $25.70 | Professional | 55 · Aftercare only | $9.77 | $16.22 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $10.72 Typical High $16.98 | Professional | 56 · Pre-op care only | $6.61 | $10.72 | $16.98 |
Where Colorado sits
The same service costs 3.7 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· 20th of 51
$158
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.