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 $380.19 Median $3,388.44 Typical High $9,120.11 | Facility | None | $380.19 | $3,388.44 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $575.44 | Professional | None | $269.15 | $380.19 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,365.16 Median $5,754.40 Typical High $14,791.08 | Facility | None | $4,365.16 | $5,754.40 | $14,791.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $891.25 | Professional | None | $363.08 | $562.34 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,691.53 Typical High $4,365.16 | Facility | None | $588.84 | $2,691.53 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $741.31 | Professional | None | $363.08 | $512.86 | $741.31 |
Denver HMP Setting Facility Modifier None Typical Low $269.15 Median $380.19 Typical High $602.56 | Facility | None | $269.15 | $380.19 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $741.31 | Professional | None | $288.40 | $457.09 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $758.58 Typical High $3,801.89 | Facility | None | $407.38 | $758.58 | $3,801.89 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $407.38 Typical High $588.84 | Professional | None | $169.82 | $407.38 | $588.84 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,122.02 Typical High $7,244.36 | Facility | None | $489.78 | $1,122.02 | $7,244.36 |
United Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $794.33 | Professional | None | $346.74 | $524.81 | $794.33 |
6 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 $131.83 Median $177.83 Typical High $194.98 | Professional | 52 · Reduced service | $131.83 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $70.79 Typical High $77.62 | Professional | 53 · Discontinued | $53.70 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $263.03 Typical High $295.12 | Professional | 54 · Surgery only | $199.53 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $53.70 Typical High $58.88 | Professional | 55 · Aftercare only | $39.81 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $35.48 Typical High $38.90 | Professional | 56 · Pre-op care only | $26.92 | $35.48 | $38.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $169.82 Median $234.42 Typical High $354.81 | Professional | 62 · Two surgeons | $169.82 | $234.42 | $354.81 |
Where Colorado sits
The same service costs 3.9 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· 12th of 51
$575
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.