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 $138.04 Typical High $7,585.78 | Facility | None | $61.66 | $138.04 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $85.11 Typical High $144.54 | Professional | None | $48.98 | $85.11 | $144.54 |
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 $114.82 | Professional | None | $54.95 | $77.62 | $114.82 |
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 $60.26 Median $100.00 Typical High $154.88 | Professional | None | $60.26 | $100.00 | $154.88 |
Denver HMP Setting Facility Modifier None Typical Low $48.98 Median $85.11 Typical High $169.82 | Facility | None | $48.98 | $85.11 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $85.11 Typical High $144.54 | Professional | None | $46.77 | $85.11 | $144.54 |
Select Health Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $177.83 | Facility | None | $85.11 | $85.11 | $177.83 |
Select Health Setting Professional Modifier None Typical Low $29.51 Median $81.28 Typical High $165.96 | Professional | None | $29.51 | $81.28 | $165.96 |
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 $58.88 Median $100.00 Typical High $173.78 | Professional | None | $58.88 | $100.00 | $173.78 |
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 $24.55 Median $34.67 Typical High $42.66 | Professional | 52 · Reduced service | $24.55 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $13.80 Typical High $16.98 | Professional | 53 · Discontinued | $9.77 | $13.80 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $52.48 Typical High $63.10 | Professional | 54 · Surgery only | $37.15 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $10.47 Typical High $12.59 | Professional | 55 · Aftercare only | $7.41 | $10.47 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $6.92 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.90 | $6.92 | $8.51 |
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· 21st of 51
$97.72
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.