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 $154.88 Median $154.88 Typical High $3,388.44 | Professional | None | $154.88 | $154.88 | $3,388.44 |
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 $204.17 Median $281.84 Typical High $426.58 | Professional | None | $204.17 | $281.84 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $269.15 Typical High $1,659.59 | Facility | None | $208.93 | $269.15 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $346.74 | Professional | None | $194.98 | $257.04 | $346.74 |
Denver HMP Setting Facility Modifier None Typical Low $154.88 Median $218.78 Typical High $269.15 | Facility | None | $154.88 | $218.78 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $346.74 | Professional | None | $154.88 | $223.87 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $275.42 Typical High $331.13 | Facility | None | $154.88 | $275.42 | $331.13 |
Select Health Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $302.00 | Professional | None | $109.65 | $154.88 | $302.00 |
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 $208.93 Median $257.04 Typical High $398.11 | Professional | None | $208.93 | $257.04 | $398.11 |
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 $77.62 Median $77.62 Typical High $100.00 | Professional | 52 · Reduced service | $77.62 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $39.81 | Professional | 53 · Discontinued | $30.90 | $30.90 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $151.36 | Professional | 54 · Surgery only | $114.82 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $30.20 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $19.95 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $19.95 |
Where Colorado sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 8th of 51
$331
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.