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 $158.49 Median $204.17 Typical High $954.99 | Professional | None | $158.49 | $204.17 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $398.11 | Professional | None | $169.82 | $257.04 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $199.53 Typical High $1,659.59 | Facility | None | $114.82 | $199.53 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $316.23 | Professional | None | $165.96 | $223.87 | $316.23 |
Denver HMP Setting Facility Modifier None Typical Low $158.49 Median $208.93 Typical High $295.12 | Facility | None | $158.49 | $208.93 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $331.13 | Professional | None | $141.25 | $218.78 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $141.25 Median $190.55 Typical High $398.11 | Facility | None | $141.25 | $190.55 | $398.11 |
Select Health Setting Professional Modifier None Typical Low $89.13 Median $190.55 Typical High $371.54 | Professional | None | $89.13 | $190.55 | $371.54 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,122.02 Typical High $2,884.03 | Facility | None | $489.78 | $1,122.02 | $2,884.03 |
United Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $354.81 | Professional | None | $169.82 | $234.42 | $354.81 |
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 $79.43 Median $91.20 Typical High $102.33 | Professional | 52 · Reduced service | $79.43 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $32.36 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $134.90 Typical High $154.88 | Professional | 54 · Surgery only | $120.23 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.92 Typical High $30.90 | Professional | 55 · Aftercare only | $23.99 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.20 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.85 | $18.20 | $20.42 |
Where Colorado sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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· 12th of 51
$269
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.