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 $66.07 Median $3,162.28 Typical High $7,762.47 | Facility | None | $66.07 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $93.33 Typical High $134.90 | Professional | None | $44.67 | $93.33 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $100.00 Typical High $173.78 | Professional | None | $53.70 | $100.00 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $107.15 Typical High $165.96 | Professional | None | $54.95 | $107.15 | $165.96 |
Denver HMP Setting Facility Modifier None Typical Low $44.67 Median $102.33 Typical High $169.82 | Facility | None | $44.67 | $102.33 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $95.50 Typical High $165.96 | Professional | None | $46.77 | $95.50 | $165.96 |
Select Health Setting Facility Modifier None Typical Low $75.86 Median $95.50 Typical High $199.53 | Facility | None | $75.86 | $95.50 | $199.53 |
Select Health Setting Professional Modifier None Typical Low $36.31 Median $46.77 Typical High $95.50 | Professional | None | $36.31 | $46.77 | $95.50 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,548.82 Typical High $3,162.28 | Facility | None | $758.58 | $1,548.82 | $3,162.28 |
United Setting Professional Modifier None Typical Low $52.48 Median $100.00 Typical High $165.96 | Professional | None | $52.48 | $100.00 | $165.96 |
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 $21.88 Median $42.66 Typical High $48.98 | Professional | 52 · Reduced service | $21.88 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $16.98 Typical High $19.50 | Professional | 53 · Discontinued | $8.91 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $64.57 Typical High $72.44 | Professional | 54 · Surgery only | $33.11 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $12.88 Typical High $14.45 | Professional | 55 · Aftercare only | $6.61 | $12.88 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $8.51 Typical High $9.77 | Professional | 56 · Pre-op care only | $4.47 | $8.51 | $9.77 |
Where Colorado sits
The same service costs 2.5 times more in North Carolina than in Florida. 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· 25th of 51
$100
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.