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 $1,513.56 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,513.56 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $5,495.41 | Professional | None | $186.21 | $186.21 | $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 $724.44 Median $1,023.29 Typical High $1,513.56 | Professional | None | $724.44 | $1,023.29 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,454.71 Typical High $3,235.94 | Facility | None | $758.58 | $2,454.71 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $562.34 Typical High $933.25 | Professional | None | $181.97 | $562.34 | $933.25 |
Denver HMP Setting Facility Modifier None Typical Low $186.21 Median $234.42 Typical High $812.83 | Facility | None | $186.21 | $234.42 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $1,174.90 | Professional | None | $588.84 | $831.76 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $588.84 Median $1,174.90 Typical High $2,884.03 | Facility | None | $588.84 | $1,174.90 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $1,148.15 | Professional | None | $416.87 | $588.84 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,762.47 | Facility | None | $1,288.25 | $2,511.89 | $7,762.47 |
United Setting Professional Modifier None Typical Low $100.00 Median $933.25 Typical High $1,445.44 | Professional | None | $100.00 | $933.25 | $1,445.44 |
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 $93.33 Median $93.33 Typical High $316.23 | Professional | 52 · Reduced service | $93.33 | $93.33 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $125.89 | Professional | 53 · Discontinued | $37.15 | $37.15 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $478.63 | Professional | 54 · Surgery only | $138.04 | $138.04 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $95.50 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $63.10 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $63.10 |
Where Colorado sits
The same service costs 53.7 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
$1,288
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.