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 $173.78 Median $3,235.94 Typical High $7,762.47 | Facility | None | $173.78 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $239.88 Typical High $323.59 | Professional | None | $112.20 | $239.88 | $323.59 |
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 $190.55 Typical High $281.84 | Professional | None | $141.25 | $190.55 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $281.84 Typical High $524.81 | Professional | None | $141.25 | $281.84 | $524.81 |
Denver HMP Setting Facility Modifier None Typical Low $112.20 Median $218.78 Typical High $354.81 | Facility | None | $112.20 | $218.78 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $239.88 Typical High $489.78 | Professional | None | $125.89 | $239.88 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $204.17 Median $251.19 Typical High $524.81 | Facility | None | $204.17 | $251.19 | $524.81 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $173.78 Typical High $251.19 | Professional | None | $91.20 | $173.78 | $251.19 |
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 $138.04 Median $263.03 Typical High $489.78 | Professional | None | $138.04 | $263.03 | $489.78 |
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 $56.23 Median $104.71 Typical High $138.04 | Professional | 52 · Reduced service | $56.23 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $41.69 Typical High $54.95 | Professional | 53 · Discontinued | $22.39 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $154.88 Typical High $204.17 | Professional | 54 · Surgery only | $85.11 | $154.88 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $31.62 Typical High $40.74 | Professional | 55 · Aftercare only | $16.98 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $20.89 Typical High $27.54 | Professional | 56 · Pre-op care only | $11.22 | $20.89 | $27.54 |
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· 29th of 51
$245
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.