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 $1,148.15 Median $3,388.44 Typical High $8,709.64 | Facility | None | $1,148.15 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $5,495.41 | Professional | None | $109.65 | $109.65 | $5,495.41 |
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 $128.82 Median $181.97 Typical High $269.15 | Professional | None | $128.82 | $181.97 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $1,659.59 | Facility | None | $416.87 | $616.60 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $223.87 | Professional | None | $117.49 | $165.96 | $223.87 |
Denver HMP Setting Facility Modifier None Typical Low $109.65 Median $141.25 Typical High $275.42 | Facility | None | $109.65 | $141.25 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $229.09 | Professional | None | $109.65 | $154.88 | $229.09 |
Select Health Setting Facility Modifier None Typical Low $109.65 Median $218.78 Typical High $645.65 | Facility | None | $109.65 | $218.78 | $645.65 |
Select Health Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $213.80 | Professional | None | $75.86 | $109.65 | $213.80 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,174.90 Typical High $2,951.21 | Facility | None | $489.78 | $1,174.90 | $2,951.21 |
United Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $257.04 | Professional | None | $123.03 | $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 $54.95 Median $54.95 Typical High $66.07 | Professional | 52 · Reduced service | $54.95 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $26.30 | Professional | 53 · Discontinued | $21.88 | $21.88 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $97.72 | Professional | 54 · Surgery only | $83.18 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $19.50 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $13.18 |
Where Colorado sits
The same service costs 4.4 times more in Alaska than in New York. 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· 15th of 51
$229
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.