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 $588.84 Median $3,311.31 Typical High $8,709.64 | Facility | None | $588.84 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $5,495.41 | Professional | None | $354.81 | $354.81 | $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 $407.38 Median $562.34 Typical High $831.76 | Professional | None | $407.38 | $562.34 | $831.76 |
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 $407.38 Median $512.86 Typical High $676.08 | Professional | None | $407.38 | $512.86 | $676.08 |
Denver HMP Setting Facility Modifier None Typical Low $354.81 Median $478.63 Typical High $776.25 | Facility | None | $354.81 | $478.63 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $660.69 | Professional | None | $309.03 | $446.68 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $630.96 Typical High $4,570.88 | Facility | None | $309.03 | $630.96 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $602.56 | Professional | None | $218.78 | $309.03 | $602.56 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $812.83 | Professional | None | $407.38 | $537.03 | $812.83 |
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 $177.83 Median $177.83 Typical High $229.09 | Professional | 52 · Reduced service | $177.83 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $91.20 | Professional | 53 · Discontinued | $70.79 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $338.84 | Professional | 54 · Surgery only | $269.15 | $269.15 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $69.18 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $45.71 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $45.71 |
Where Colorado sits
The same service costs 7.8 times more in Oklahoma 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· 13th of 51
$708
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.