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 $74.13 Median $3,235.94 Typical High $8,912.51 | Facility | None | $74.13 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $58.88 Typical High $74.13 | Professional | None | $56.23 | $58.88 | $74.13 |
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 $52.48 Median $66.07 Typical High $114.82 | Professional | None | $52.48 | $66.07 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $56.23 Typical High $95.50 | Facility | None | $41.69 | $56.23 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $67.61 Typical High $97.72 | Professional | None | $48.98 | $67.61 | $97.72 |
Denver HMP Setting Facility Modifier None Typical Low $56.23 Median $77.62 Typical High $114.82 | Facility | None | $56.23 | $77.62 | $114.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $47.86 Median $67.61 Typical High $100.00 | Professional | None | $47.86 | $67.61 | $100.00 |
Select Health Setting Facility Modifier None Typical Low $51.29 Median $64.57 Typical High $134.90 | Facility | None | $51.29 | $64.57 | $134.90 |
Select Health Setting Professional Modifier None Typical Low $28.18 Median $48.98 Typical High $64.57 | Professional | None | $28.18 | $48.98 | $64.57 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $117.49 | Professional | None | $53.70 | $70.79 | $117.49 |
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 $28.18 Median $29.51 Typical High $37.15 | Professional | 52 · Reduced service | $28.18 | $29.51 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.75 Typical High $14.79 | Professional | 53 · Discontinued | $11.22 | $11.75 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $43.65 Typical High $56.23 | Professional | 54 · Surgery only | $42.66 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.71 Typical High $11.22 | Professional | 55 · Aftercare only | $8.51 | $8.71 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.89 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.62 | $5.89 | $7.41 |
Where Colorado sits
The same service costs 3.7 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· 23rd of 51
$77.62
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.