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 $2,570.40 Median $3,235.94 Typical High $8,912.51 | Facility | None | $2,570.40 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $933.25 | Professional | None | $173.78 | $173.78 | $933.25 |
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 $229.09 Median $323.59 Typical High $478.63 | Professional | None | $229.09 | $323.59 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $213.80 Typical High $389.05 | Facility | None | $52.48 | $213.80 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $398.11 | Professional | None | $218.78 | $288.40 | $398.11 |
Denver HMP Setting Facility Modifier None Typical Low $173.78 Median $245.47 Typical High $316.23 | Facility | None | $173.78 | $245.47 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $371.54 | Professional | None | $173.78 | $251.19 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $275.42 Typical High $371.54 | Facility | None | $173.78 | $275.42 | $371.54 |
Select Health Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $338.84 | Professional | None | $123.03 | $173.78 | $338.84 |
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 $234.42 Median $295.12 Typical High $457.09 | Professional | None | $234.42 | $295.12 | $457.09 |
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 $87.10 Median $87.10 Typical High $112.20 | Professional | 52 · Reduced service | $87.10 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $45.71 | Professional | 53 · Discontinued | $34.67 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $169.82 | Professional | 54 · Surgery only | $128.82 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $33.88 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $22.39 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $22.39 |
Where Colorado sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 11th of 51
$347
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.