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 $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $416.87 | Professional | None | $95.50 | $95.50 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $263.03 | Professional | None | $128.82 | $177.83 | $263.03 |
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 $112.20 Median $158.49 Typical High $218.78 | Professional | None | $112.20 | $158.49 | $218.78 |
Denver HMP Setting Facility Modifier None Typical Low $95.50 Median $134.90 Typical High $158.49 | Facility | None | $95.50 | $134.90 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $199.53 | Professional | None | $95.50 | $134.90 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $95.50 Median $190.55 Typical High $275.42 | Facility | None | $95.50 | $190.55 | $275.42 |
Select Health Setting Professional Modifier None Typical Low $67.61 Median $95.50 Typical High $186.21 | Professional | None | $67.61 | $95.50 | $186.21 |
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 $125.89 Median $162.18 Typical High $257.04 | Professional | None | $125.89 | $162.18 | $257.04 |
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 $47.86 Median $47.86 Typical High $58.88 | Professional | 52 · Reduced service | $47.86 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $23.99 | Professional | 53 · Discontinued | $19.50 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $72.44 Typical High $89.13 | Professional | 54 · Surgery only | $72.44 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $17.78 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $12.02 |
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· 11th of 51
$178
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.