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 $138.04 Median $3,162.28 Typical High $8,912.51 | Facility | None | $138.04 | $3,162.28 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $141.25 | Professional | None | $100.00 | $120.23 | $141.25 |
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 $109.65 Median $144.54 Typical High $245.47 | Professional | None | $109.65 | $144.54 | $245.47 |
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 $93.33 Median $125.89 Typical High $181.97 | Professional | None | $93.33 | $125.89 | $181.97 |
Denver HMP Setting Facility Modifier None Typical Low $120.23 Median $147.91 Typical High $218.78 | Facility | None | $120.23 | $147.91 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $181.97 | Professional | None | $95.50 | $141.25 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $120.23 Median $173.78 Typical High $251.19 | Facility | None | $120.23 | $173.78 | $251.19 |
Select Health Setting Professional Modifier None Typical Low $61.66 Median $104.71 Typical High $125.89 | Professional | None | $61.66 | $104.71 | $125.89 |
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 $100.00 Median $134.90 Typical High $223.87 | Professional | None | $100.00 | $134.90 | $223.87 |
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 $51.29 Median $60.26 Typical High $69.18 | Professional | 52 · Reduced service | $51.29 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $23.99 Typical High $27.54 | Professional | 53 · Discontinued | $20.42 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $89.13 Typical High $102.33 | Professional | 54 · Surgery only | $77.62 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $17.78 Typical High $20.42 | Professional | 55 · Aftercare only | $15.49 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.02 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.23 | $12.02 | $13.80 |
Where Colorado sits
The same service costs 4.5 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· 21st of 51
$151
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.