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 $223.87 Median $223.87 Typical High $1,659.59 | Professional | None | $223.87 | $223.87 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $537.03 | Professional | None | $257.04 | $363.08 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,344.23 Typical High $4,786.30 | Facility | None | $676.08 | $2,344.23 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $416.87 | Professional | None | $245.47 | $323.59 | $416.87 |
Denver HMP Setting Facility Modifier None Typical Low $204.17 Median $223.87 Typical High $338.84 | Facility | None | $204.17 | $223.87 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $281.84 | Professional | None | $134.90 | $186.21 | $281.84 |
Select Health Setting Facility Modifier None Typical Low $134.90 Median $269.15 Typical High $281.84 | Facility | None | $134.90 | $269.15 | $281.84 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $263.03 | Professional | None | $93.33 | $134.90 | $263.03 |
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 $208.93 Median $269.15 Typical High $436.52 | Professional | None | $208.93 | $269.15 | $436.52 |
3 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 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $199.53 | Professional | 54 · Surgery only | $169.82 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $26.30 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $26.30 |
Where Colorado sits
The same service costs 8.5 times more in New York than in Kentucky. 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· 16th of 51
$447
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.