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 $93.33 Median $3,162.28 Typical High $7,762.47 | Facility | None | $93.33 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $109.65 Typical High $154.88 | Professional | None | $52.48 | $109.65 | $154.88 |
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 $63.10 Median $89.13 Typical High $131.83 | Professional | None | $63.10 | $89.13 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $190.55 Typical High $1,659.59 | Facility | None | $109.65 | $190.55 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $131.83 Typical High $199.53 | Professional | None | $75.86 | $131.83 | $199.53 |
Denver HMP Setting Facility Modifier None Typical Low $52.48 Median $125.89 Typical High $181.97 | Facility | None | $52.48 | $125.89 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $112.20 Typical High $208.93 | Professional | None | $60.26 | $112.20 | $208.93 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $263.03 | Facility | None | $100.00 | $131.83 | $263.03 |
Select Health Setting Professional Modifier None Typical Low $53.70 Median $66.07 Typical High $125.89 | Professional | None | $53.70 | $66.07 | $125.89 |
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 $70.79 Median $128.82 Typical High $208.93 | Professional | None | $70.79 | $128.82 | $208.93 |
6 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 $26.30 Median $51.29 Typical High $53.70 | Professional | 52 · Reduced service | $26.30 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $20.89 Typical High $21.88 | Professional | 53 · Discontinued | $10.47 | $20.89 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $77.62 Typical High $81.28 | Professional | 54 · Surgery only | $39.81 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $15.49 Typical High $16.22 | Professional | 55 · Aftercare only | $7.94 | $15.49 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $10.47 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.25 | $10.47 | $10.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $93.33 Median $128.82 Typical High $177.83 | Professional | 50 · Both sides | $93.33 | $128.82 | $177.83 |
Where Colorado sits
The same service costs 3.2 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· 33rd of 51
$115
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.