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 $158.49 Median $3,235.94 Typical High $7,762.47 | Facility | None | $158.49 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $181.97 | Professional | None | $112.20 | $158.49 | $181.97 |
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 $131.83 Median $186.21 Typical High $275.42 | Professional | None | $131.83 | $186.21 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $128.82 Typical High $758.58 | Facility | None | $66.07 | $128.82 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $263.03 | Professional | None | $131.83 | $177.83 | $263.03 |
Denver HMP Setting Facility Modifier None Typical Low $112.20 Median $158.49 Typical High $263.03 | Facility | None | $112.20 | $158.49 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $288.40 | Professional | None | $123.03 | $190.55 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $173.78 Typical High $363.08 | Facility | None | $147.91 | $173.78 | $363.08 |
Select Health Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $173.78 | Professional | None | $114.82 | $134.90 | $173.78 |
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 $128.82 Median $181.97 Typical High $302.00 | Professional | None | $128.82 | $181.97 | $302.00 |
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 $75.86 Typical High $79.43 | Professional | 52 · Reduced service | $56.23 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $30.90 Typical High $31.62 | Professional | 53 · Discontinued | $22.39 | $30.90 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $114.82 Typical High $120.23 | Professional | 54 · Surgery only | $85.11 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $22.91 Typical High $23.99 | Professional | 55 · Aftercare only | $16.98 | $22.91 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.14 Typical High $15.85 | Professional | 56 · Pre-op care only | $11.22 | $15.14 | $15.85 |
Where Colorado sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 24th of 51
$186
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.