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 $2,570.40 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | None | $104.71 | $104.71 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $426.58 Median $3,311.31 Typical High $5,370.32 | Facility | None | $426.58 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $218.78 | Professional | None | $117.49 | $158.49 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $190.55 | Professional | None | $117.49 | $134.90 | $190.55 |
Denver HMP Setting Facility Modifier None Typical Low $104.71 Median $141.25 Typical High $234.42 | Facility | None | $104.71 | $141.25 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $204.17 | Professional | None | $107.15 | $131.83 | $204.17 |
Select Health Setting Facility Modifier None Typical Low $93.33 Median $186.21 Typical High $194.98 | Facility | None | $93.33 | $186.21 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $147.91 | Professional | None | $87.10 | $102.33 | $147.91 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $218.78 | Professional | None | $109.65 | $134.90 | $218.78 |
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 $52.48 Median $52.48 Typical High $63.10 | Professional | 52 · Reduced service | $52.48 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $25.12 | Professional | 53 · Discontinued | $20.89 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $79.43 Typical High $93.33 | Professional | 54 · Surgery only | $77.62 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.85 Typical High $18.62 | Professional | 55 · Aftercare only | $15.49 | $15.85 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $12.59 |
Where Colorado sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 22nd of 51
$151
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.