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 $616.60 Median $3,235.94 Typical High $8,912.51 | Facility | None | $616.60 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $1,698.24 Typical High $3,981.07 | Professional | None | $398.11 | $1,698.24 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $1,513.56 Typical High $3,548.13 | Professional | None | $478.63 | $1,513.56 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,570.40 Typical High $6,760.83 | Facility | None | $831.76 | $2,570.40 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $933.25 Typical High $3,019.95 | Professional | None | $457.09 | $933.25 | $3,019.95 |
Denver HMP Setting Facility Modifier None Typical Low $398.11 Median $954.99 Typical High $5,623.41 | Facility | None | $398.11 | $954.99 | $5,623.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $1,513.56 Typical High $5,888.44 | Professional | None | $398.11 | $1,513.56 | $5,888.44 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $7,585.78 | Facility | None | $724.44 | $2,884.03 | $7,585.78 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $707.95 Typical High $7,079.46 | Professional | None | $251.19 | $707.95 | $7,079.46 |
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 $478.63 Median $1,778.28 Typical High $3,311.31 | Professional | None | $478.63 | $1,778.28 | $3,311.31 |
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 $199.53 Median $741.31 Typical High $891.25 | Professional | 52 · Reduced service | $199.53 | $741.31 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $295.12 Typical High $354.81 | Professional | 53 · Discontinued | $79.43 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $1,096.48 Typical High $1,348.96 | Professional | 54 · Surgery only | $295.12 | $1,096.48 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $218.78 Typical High $269.15 | Professional | 55 · Aftercare only | $58.88 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $147.91 Typical High $177.83 | Professional | 56 · Pre-op care only | $39.81 | $147.91 | $177.83 |
Where Colorado sits
The same service costs 3.6 times more in Iowa than in Nebraska. 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· 9th of 51
$2,239
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.