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 $269.15 Median $346.74 Typical High $954.99 | Professional | None | $269.15 | $346.74 | $954.99 |
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 $354.81 Median $489.78 Typical High $724.44 | Professional | None | $354.81 | $489.78 | $724.44 |
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 $338.84 Median $489.78 Typical High $707.95 | Professional | None | $338.84 | $489.78 | $707.95 |
Denver HMP Setting Facility Modifier None Typical Low $269.15 Median $426.58 Typical High $616.60 | Facility | None | $269.15 | $426.58 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $691.83 | Professional | None | $295.12 | $457.09 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $257.04 Median $407.38 Typical High $851.14 | Facility | None | $257.04 | $407.38 | $851.14 |
Select Health Setting Professional Modifier None Typical Low $186.21 Median $407.38 Typical High $794.33 | Professional | None | $186.21 | $407.38 | $794.33 |
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 $354.81 Median $512.86 Typical High $794.33 | Professional | None | $354.81 | $512.86 | $794.33 |
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 $134.90 Median $173.78 Typical High $194.98 | Professional | 52 · Reduced service | $134.90 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $69.18 Typical High $77.62 | Professional | 53 · Discontinued | $53.70 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $263.03 Typical High $295.12 | Professional | 54 · Surgery only | $199.53 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $52.48 Typical High $58.88 | Professional | 55 · Aftercare only | $39.81 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $34.67 Typical High $38.90 | Professional | 56 · Pre-op care only | $26.92 | $34.67 | $38.90 |
Where Colorado sits
The same service costs 2.9 times more in Alaska than in Kentucky. 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· 12th of 51
$537
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.