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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $338.84 | Professional | None | $128.82 | $208.93 | $338.84 |
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 $154.88 Median $251.19 Typical High $436.52 | Professional | None | $154.88 | $251.19 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,071.52 Typical High $1,659.59 | Facility | None | $436.52 | $1,071.52 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $346.74 | Professional | None | $144.54 | $213.80 | $346.74 |
Denver HMP Setting Facility Modifier None Typical Low $141.25 Median $223.87 Typical High $338.84 | Facility | None | $141.25 | $223.87 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $363.08 | Professional | None | $114.82 | $208.93 | $363.08 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $389.05 Typical High $1,230.27 | Facility | None | $208.93 | $389.05 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $74.13 Median $204.17 Typical High $407.38 | Professional | None | $74.13 | $204.17 | $407.38 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $398.11 | Professional | None | $144.54 | $234.42 | $398.11 |
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 $70.79 Median $100.00 Typical High $117.49 | Professional | 52 · Reduced service | $70.79 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $39.81 Typical High $46.77 | Professional | 53 · Discontinued | $28.18 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $147.91 Typical High $177.83 | Professional | 54 · Surgery only | $104.71 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $29.51 Typical High $35.48 | Professional | 55 · Aftercare only | $20.89 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $19.95 Typical High $23.44 | Professional | 56 · Pre-op care only | $14.13 | $19.95 | $23.44 |
Where Colorado sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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
$282
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.