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 $478.63 Median $478.63 Typical High $5,495.41 | Professional | None | $478.63 | $478.63 | $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 $537.03 Median $758.58 Typical High $1,122.02 | Professional | None | $537.03 | $758.58 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $2,691.53 Typical High $5,128.61 | Facility | None | $436.52 | $2,691.53 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $912.01 | Professional | None | $512.86 | $676.08 | $912.01 |
Denver HMP Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $1,023.29 | Facility | None | $426.58 | $602.56 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $870.96 | Professional | None | $416.87 | $588.84 | $870.96 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $831.76 Typical High $4,570.88 | Facility | None | $416.87 | $831.76 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $812.83 | Professional | None | $288.40 | $416.87 | $812.83 |
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 $549.54 Median $707.95 Typical High $1,096.48 | Professional | None | $549.54 | $707.95 | $1,096.48 |
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 $234.42 Median $234.42 Typical High $302.00 | Professional | 52 · Reduced service | $234.42 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $120.23 | Professional | 53 · Discontinued | $95.50 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $457.09 | Professional | 54 · Surgery only | $354.81 | $354.81 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $91.20 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $60.26 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $60.26 |
Where Colorado sits
The same service costs 4.4 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· 11th of 51
$891
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.