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 $446.68 Median $3,548.13 Typical High $10,715.19 | Facility | None | $446.68 | $3,548.13 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $316.23 Typical High $2,398.83 | Professional | None | $281.84 | $316.23 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $741.31 | Professional | None | $363.08 | $512.86 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,754.23 Typical High $4,365.16 | Facility | None | $691.83 | $2,754.23 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $630.96 | Professional | None | $363.08 | $467.74 | $630.96 |
Denver HMP Setting Facility Modifier None Typical Low $281.84 Median $407.38 Typical High $588.84 | Facility | None | $281.84 | $407.38 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $691.83 | Professional | None | $275.42 | $389.05 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $549.54 Typical High $3,801.89 | Facility | None | $275.42 | $549.54 | $3,801.89 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $537.03 | Professional | None | $190.55 | $275.42 | $537.03 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,801.89 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,801.89 | $11,220.18 |
United Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $724.44 | Professional | None | $389.05 | $501.19 | $724.44 |
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 $141.25 Median $141.25 Typical High $173.78 | Professional | 52 · Reduced service | $141.25 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $70.79 | Professional | 53 · Discontinued | $57.54 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $263.03 | Professional | 54 · Surgery only | $213.80 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $52.48 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $34.67 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $34.67 |
Where Colorado sits
The same service costs 10.0 times more in Oklahoma 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· 18th of 51
$631
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.