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 $138.04 Median $281.84 Typical High $380.19 | Professional | None | $138.04 | $281.84 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $346.74 | Professional | None | $173.78 | $234.42 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $338.84 Typical High $676.08 | Professional | None | $177.83 | $338.84 | $676.08 |
Denver HMP Setting Facility Modifier None Typical Low $138.04 Median $302.00 Typical High $467.74 | Facility | None | $138.04 | $302.00 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $331.13 Typical High $676.08 | Professional | None | $169.82 | $331.13 | $676.08 |
Select Health Setting Facility Modifier None Typical Low $269.15 Median $354.81 Typical High $741.31 | Facility | None | $269.15 | $354.81 | $741.31 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $229.09 Typical High $354.81 | Professional | None | $112.20 | $229.09 | $354.81 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $2,754.23 | Facility | None | $758.58 | $1,513.56 | $2,754.23 |
United Setting Professional Modifier None Typical Low $177.83 Median $338.84 Typical High $630.96 | Professional | None | $177.83 | $338.84 | $630.96 |
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 $69.18 Median $134.90 Typical High $177.83 | Professional | 52 · Reduced service | $69.18 | $134.90 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $53.70 Typical High $70.79 | Professional | 53 · Discontinued | $27.54 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $199.53 Typical High $263.03 | Professional | 54 · Surgery only | $102.33 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $39.81 Typical High $52.48 | Professional | 55 · Aftercare only | $20.42 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $26.92 Typical High $35.48 | Professional | 56 · Pre-op care only | $13.80 | $26.92 | $35.48 |
Where Colorado sits
The same service costs 3.5 times more in Alaska than in Virginia. 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· 38th of 51
$282
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.