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 $1,148.15 Median $3,388.44 Typical High $8,709.64 | Facility | None | $1,148.15 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $5,495.41 | Professional | None | $562.34 | $562.34 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $1,318.26 | Professional | None | $645.65 | $891.25 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,248.07 Typical High $9,549.93 | Facility | None | $758.58 | $5,248.07 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,096.48 | Professional | None | $630.96 | $812.83 | $1,096.48 |
Denver HMP Setting Facility Modifier None Typical Low $512.86 Median $724.44 Typical High $1,230.27 | Facility | None | $512.86 | $724.44 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,023.29 | Professional | None | $489.78 | $691.83 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $489.78 Median $977.24 Typical High $8,317.64 | Facility | None | $489.78 | $977.24 | $8,317.64 |
Select Health Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $954.99 | Professional | None | $346.74 | $489.78 | $954.99 |
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 $645.65 Median $851.14 Typical High $1,288.25 | Professional | None | $645.65 | $851.14 | $1,288.25 |
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 $281.84 Median $281.84 Typical High $363.08 | Professional | 52 · Reduced service | $281.84 | $281.84 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $144.54 | Professional | 53 · Discontinued | $112.20 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $537.03 | Professional | 54 · Surgery only | $426.58 | $426.58 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $107.15 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $72.44 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $72.44 |
Where Colorado sits
The same service costs 3.9 times more in Alaska than in New York. 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· 12th of 51
$1,072
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.