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 $83.18 Median $102.33 Typical High $134.90 | Professional | None | $83.18 | $102.33 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $239.88 | Professional | None | $100.00 | $151.36 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $229.09 | Professional | None | $89.13 | $128.82 | $229.09 |
Denver HMP Setting Facility Modifier None Typical Low $91.20 Median $123.03 Typical High $177.83 | Facility | None | $91.20 | $123.03 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $223.87 | Professional | None | $89.13 | $141.25 | $223.87 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $147.91 Typical High $239.88 | Facility | None | $114.82 | $147.91 | $239.88 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $114.82 Typical High $177.83 | Professional | None | $63.10 | $114.82 | $177.83 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $2,754.23 | Facility | None | $758.58 | $1,513.56 | $2,754.23 |
United Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $213.80 | Professional | None | $83.18 | $128.82 | $213.80 |
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 $41.69 Median $51.29 Typical High $61.66 | Professional | 52 · Reduced service | $41.69 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $20.42 Typical High $24.55 | Professional | 53 · Discontinued | $16.60 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $75.86 Typical High $93.33 | Professional | 54 · Surgery only | $61.66 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.49 Typical High $18.62 | Professional | 55 · Aftercare only | $12.30 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.23 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.32 | $10.23 | $12.30 |
Where Colorado sits
The same service costs 3.8 times more in Alaska 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· 13th of 51
$138
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.