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 $67.61 Median $2,570.40 Typical High $7,585.78 | Facility | None | $67.61 | $2,570.40 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $87.10 Typical High $177.83 | Professional | None | $46.77 | $87.10 | $177.83 |
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 $63.10 Median $128.82 Typical High $234.42 | Professional | None | $63.10 | $128.82 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,698.24 | Facility | None | $50.12 | $66.07 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $177.83 | Professional | None | $61.66 | $89.13 | $177.83 |
Denver HMP Setting Facility Modifier None Typical Low $46.77 Median $95.50 Typical High $144.54 | Facility | None | $46.77 | $95.50 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $47.86 Median $95.50 Typical High $186.21 | Professional | None | $47.86 | $95.50 | $186.21 |
Select Health Setting Facility Modifier None Typical Low $87.10 Median $109.65 Typical High $229.09 | Facility | None | $87.10 | $109.65 | $229.09 |
Select Health Setting Professional Modifier None Typical Low $30.90 Median $85.11 Typical High $213.80 | Professional | None | $30.90 | $85.11 | $213.80 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $190.55 | Professional | None | $63.10 | $100.00 | $190.55 |
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 $22.91 Median $44.67 Typical High $51.29 | Professional | 52 · Reduced service | $22.91 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $17.78 Typical High $20.42 | Professional | 53 · Discontinued | $9.33 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $67.61 Typical High $75.86 | Professional | 54 · Surgery only | $34.67 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $13.49 Typical High $15.14 | Professional | 55 · Aftercare only | $6.92 | $13.49 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $8.91 Typical High $10.23 | Professional | 56 · Pre-op care only | $4.68 | $8.91 | $10.23 |
Where Colorado sits
The same service costs 3.2 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· 9th of 51
$129
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.