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 $3,162.28 Typical High $8,912.51 | Facility | None | $74.13 | $3,162.28 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $91.20 Typical High $147.91 | Professional | None | $46.77 | $91.20 | $147.91 |
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 $54.95 Median $77.62 Typical High $112.20 | Professional | None | $54.95 | $77.62 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $141.25 Typical High $1,659.59 | Facility | None | $81.28 | $141.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $109.65 Typical High $173.78 | Professional | None | $56.23 | $109.65 | $173.78 |
Denver HMP Setting Facility Modifier None Typical Low $47.86 Median $100.00 Typical High $141.25 | Facility | None | $47.86 | $100.00 | $141.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $83.18 Typical High $162.18 | Professional | None | $41.69 | $83.18 | $162.18 |
Select Health Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $204.17 | Facility | None | $75.86 | $100.00 | $204.17 |
Select Health Setting Professional Modifier None Typical Low $26.30 Median $74.13 Typical High $186.21 | Professional | None | $26.30 | $74.13 | $186.21 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,862.09 | Facility | None | $239.88 | $616.60 | $1,862.09 |
United Setting Professional Modifier None Typical Low $56.23 Median $112.20 Typical High $190.55 | Professional | None | $56.23 | $112.20 | $190.55 |
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 $38.90 Typical High $50.12 | Professional | 52 · Reduced service | $23.99 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $15.49 Typical High $19.95 | Professional | 53 · Discontinued | $9.55 | $15.49 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $58.88 Typical High $74.13 | Professional | 54 · Surgery only | $35.48 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $11.75 Typical High $14.79 | Professional | 55 · Aftercare only | $7.08 | $11.75 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.76 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.79 | $7.76 | $10.00 |
Where Colorado sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 17th of 51
$105
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.