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 $416.87 Median $436.52 Typical High $912.01 | Professional | None | $416.87 | $436.52 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,495.41 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,495.41 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $1,148.15 | Professional | None | $549.54 | $758.58 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $2,691.53 | Facility | None | $645.65 | $2,290.87 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $912.01 | Professional | None | $501.19 | $691.83 | $912.01 |
Denver HMP Setting Facility Modifier None Typical Low $416.87 Median $588.84 Typical High $776.25 | Facility | None | $416.87 | $588.84 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $870.96 | Professional | None | $416.87 | $588.84 | $870.96 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $831.76 Typical High $870.96 | Facility | None | $416.87 | $831.76 | $870.96 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $812.83 | Professional | None | $288.40 | $416.87 | $812.83 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,096.48 | Professional | None | $562.34 | $707.95 | $1,096.48 |
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 $208.93 Median $208.93 Typical High $269.15 | Professional | 52 · Reduced service | $208.93 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $109.65 | Professional | 53 · Discontinued | $83.18 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $407.38 | Professional | 54 · Surgery only | $309.03 | $309.03 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $81.28 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $53.70 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $53.70 |
Where Colorado sits
The same service costs 3.4 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· 5th of 51
$912
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.