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 $1,258.93 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $194.98 | Professional | None | $91.20 | $144.54 | $194.98 |
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 $112.20 Median $199.53 Typical High $363.08 | Professional | None | $112.20 | $199.53 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,995.26 Typical High $2,691.53 | Facility | None | $588.84 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $281.84 | Professional | None | $104.71 | $158.49 | $281.84 |
Denver HMP Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $281.84 | Facility | None | $91.20 | $177.83 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $199.53 Typical High $346.74 | Professional | None | $104.71 | $199.53 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $169.82 Median $371.54 Typical High $2,398.83 | Facility | None | $169.82 | $371.54 | $2,398.83 |
Select Health Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $199.53 | Professional | None | $75.86 | $109.65 | $199.53 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $275.42 | Professional | None | $104.71 | $165.96 | $275.42 |
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 $67.61 Typical High $89.13 | Professional | 52 · Reduced service | $45.71 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $26.92 Typical High $36.31 | Professional | 53 · Discontinued | $18.20 | $26.92 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $102.33 Typical High $134.90 | Professional | 54 · Surgery only | $69.18 | $102.33 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $20.42 Typical High $26.92 | Professional | 55 · Aftercare only | $13.80 | $20.42 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $13.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $9.12 | $13.49 | $17.78 |
Where Colorado sits
The same service costs 3.6 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
$182
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.