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 $194.98 Median $239.88 Typical High $1,148.15 | Professional | None | $194.98 | $239.88 | $1,148.15 |
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 $257.04 Median $380.19 Typical High $575.44 | Professional | None | $257.04 | $380.19 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $331.13 Typical High $1,659.59 | Facility | None | $213.80 | $331.13 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $467.74 | Professional | None | $251.19 | $323.59 | $467.74 |
Denver HMP Setting Facility Modifier None Typical Low $194.98 Median $295.12 Typical High $371.54 | Facility | None | $194.98 | $295.12 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $467.74 | Professional | None | $199.53 | $309.03 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $257.04 Median $275.42 Typical High $549.54 | Facility | None | $257.04 | $275.42 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $128.82 Median $257.04 Typical High $501.19 | Professional | None | $128.82 | $257.04 | $501.19 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,862.09 | Facility | None | $239.88 | $616.60 | $1,862.09 |
United Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $537.03 | Professional | None | $251.19 | $338.84 | $537.03 |
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 $97.72 Median $120.23 Typical High $128.82 | Professional | 52 · Reduced service | $97.72 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $47.86 Typical High $51.29 | Professional | 53 · Discontinued | $38.90 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $177.83 Typical High $194.98 | Professional | 54 · Surgery only | $144.54 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $35.48 Typical High $38.90 | Professional | 55 · Aftercare only | $28.84 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $23.99 Typical High $25.70 | Professional | 56 · Pre-op care only | $19.50 | $23.99 | $25.70 |
Where Colorado sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 10th of 51
$389
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.