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 $114.82 Median $239.88 Typical High $331.13 | Professional | None | $114.82 | $239.88 | $331.13 |
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 $141.25 Median $194.98 Typical High $288.40 | Professional | None | $141.25 | $194.98 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $288.40 Typical High $537.03 | Professional | None | $147.91 | $288.40 | $537.03 |
Denver HMP Setting Facility Modifier None Typical Low $114.82 Median $223.87 Typical High $363.08 | Facility | None | $114.82 | $223.87 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $501.19 | Professional | None | $128.82 | $245.47 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $204.17 Median $257.04 Typical High $549.54 | Facility | None | $204.17 | $257.04 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $173.78 Typical High $257.04 | Professional | None | $93.33 | $173.78 | $257.04 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $2,511.89 Typical High $3,981.07 | Facility | None | $1,412.54 | $2,511.89 | $3,981.07 |
United Setting Professional Modifier None Typical Low $141.25 Median $269.15 Typical High $512.86 | Professional | None | $141.25 | $269.15 | $512.86 |
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 $57.54 Median $107.15 Typical High $144.54 | Professional | 52 · Reduced service | $57.54 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $43.65 Typical High $57.54 | Professional | 53 · Discontinued | $22.91 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $162.18 Typical High $213.80 | Professional | 54 · Surgery only | $85.11 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $32.36 Typical High $42.66 | Professional | 55 · Aftercare only | $16.98 | $32.36 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $21.88 Typical High $28.84 | Professional | 56 · Pre-op care only | $11.48 | $21.88 | $28.84 |
Where Colorado sits
The same service costs 3.4 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· 31st of 51
$251
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.