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 $1,258.93 Median $3,388.44 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,388.44 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $3,235.94 | Professional | None | $478.63 | $478.63 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,290.87 Median $3,548.13 Typical High $20,892.96 | Facility | None | $2,290.87 | $3,548.13 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,258.93 | Professional | None | $616.60 | $851.14 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,047.13 | Professional | None | $616.60 | $776.25 | $1,047.13 |
Denver HMP Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $691.83 | Facility | None | $478.63 | $478.63 | $691.83 |
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 $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
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 $239.88 Median $239.88 Typical High $275.42 | Professional | 52 · Reduced service | $239.88 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $109.65 | Professional | 53 · Discontinued | $95.50 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $416.87 | Professional | 54 · Surgery only | $363.08 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $54.95 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $54.95 |
Where Colorado sits
The same service costs 134.9 times more in Oklahoma than in Hawaii. 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· 10th of 51
$1,000
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.