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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $5,495.41 | Professional | None | $263.03 | $263.03 | $5,495.41 |
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 $302.00 Median $426.58 Typical High $630.96 | Professional | None | $302.00 | $426.58 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,398.83 Typical High $3,235.94 | Facility | None | $691.83 | $2,398.83 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $501.19 | Professional | None | $302.00 | $380.19 | $501.19 |
Denver HMP Setting Facility Modifier None Typical Low $263.03 Median $338.84 Typical High $575.44 | Facility | None | $263.03 | $338.84 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $478.63 | Professional | None | $229.09 | $323.59 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $229.09 Median $457.09 Typical High $2,884.03 | Facility | None | $229.09 | $457.09 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $446.68 | Professional | None | $162.18 | $229.09 | $446.68 |
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 $309.03 Median $398.11 Typical High $616.60 | Professional | None | $309.03 | $398.11 | $616.60 |
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 $199.53 Median $199.53 Typical High $257.04 | Professional | 54 · Surgery only | $199.53 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $51.29 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $33.88 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $33.88 |
Where Colorado sits
The same service costs 7.2 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· 15th of 51
$525
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.