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 $61.66 Median $2,570.40 Typical High $8,709.64 | Facility | None | $61.66 | $2,570.40 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $81.28 | Professional | None | $43.65 | $60.26 | $81.28 |
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 $45.71 Median $58.88 Typical High $100.00 | Professional | None | $45.71 | $58.88 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,698.24 | Facility | None | $50.12 | $66.07 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $58.88 Typical High $93.33 | Professional | None | $39.81 | $58.88 | $93.33 |
Denver HMP Setting Facility Modifier None Typical Low $47.86 Median $69.18 Typical High $102.33 | Facility | None | $47.86 | $69.18 | $102.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $66.07 Typical High $100.00 | Professional | None | $45.71 | $66.07 | $100.00 |
Select Health Setting Facility Modifier None Typical Low $66.07 Median $75.86 Typical High $138.04 | Facility | None | $66.07 | $75.86 | $138.04 |
Select Health Setting Professional Modifier None Typical Low $26.92 Median $41.69 Typical High $66.07 | Professional | None | $26.92 | $41.69 | $66.07 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,949.84 | Facility | None | $239.88 | $616.60 | $1,949.84 |
United Setting Professional Modifier None Typical Low $44.67 Median $64.57 Typical High $109.65 | Professional | None | $44.67 | $64.57 | $109.65 |
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 $23.99 Median $25.70 Typical High $36.31 | Professional | 52 · Reduced service | $23.99 | $25.70 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $10.23 Typical High $14.45 | Professional | 53 · Discontinued | $9.55 | $10.23 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $38.02 Typical High $53.70 | Professional | 54 · Surgery only | $36.31 | $38.02 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.59 Typical High $10.72 | Professional | 55 · Aftercare only | $7.24 | $7.59 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.13 Typical High $7.24 | Professional | 56 · Pre-op care only | $4.79 | $5.13 | $7.24 |
Where Colorado sits
The same service costs 3.8 times more in Alaska than in Maryland. 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· 21st of 51
$72.44
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.