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 $204.17 Median $3,235.94 Typical High $8,912.51 | Facility | None | $204.17 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $630.96 | Professional | None | $204.17 | $204.17 | $630.96 |
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 $229.09 Median $323.59 Typical High $478.63 | Professional | None | $229.09 | $323.59 | $478.63 |
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 $234.42 Median $288.40 Typical High $371.54 | Professional | None | $234.42 | $288.40 | $371.54 |
Denver HMP Setting Facility Modifier None Typical Low $204.17 Median $223.87 Typical High $346.74 | Facility | None | $204.17 | $223.87 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $288.40 | Professional | None | $138.04 | $194.98 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $138.04 Median $275.42 Typical High $288.40 | Facility | None | $138.04 | $275.42 | $288.40 |
Select Health Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $269.15 | Professional | None | $97.72 | $138.04 | $269.15 |
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 $165.96 Median $263.03 Typical High $436.52 | Professional | None | $165.96 | $263.03 | $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 $151.36 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $151.36 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $36.31 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $23.99 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $23.99 |
Where Colorado sits
The same service costs 10.5 times more in North Dakota 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· 11th of 51
$398
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.