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 $21.38 Median $3,235.94 Typical High $7,762.47 | Facility | None | $21.38 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $16.60 Typical High $36.31 | Professional | None | $13.80 | $16.60 | $36.31 |
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 $18.62 Median $26.30 Typical High $38.90 | Professional | None | $18.62 | $26.30 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $89.13 Typical High $1,621.81 | Facility | None | $58.88 | $89.13 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $20.42 Typical High $28.84 | Professional | None | $15.14 | $20.42 | $28.84 |
Denver HMP Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $33.11 | Facility | None | $16.60 | $16.60 | $33.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $18.20 Median $25.12 Typical High $38.02 | Professional | None | $18.20 | $25.12 | $38.02 |
Select Health Setting Facility Modifier None Typical Low $18.20 Median $33.11 Typical High $38.02 | Facility | None | $18.20 | $33.11 | $38.02 |
Select Health Setting Professional Modifier None Typical Low $12.59 Median $18.20 Typical High $35.48 | Professional | None | $12.59 | $18.20 | $35.48 |
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 $15.14 Median $19.95 Typical High $31.62 | Professional | None | $15.14 | $19.95 | $31.62 |
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 $7.08 Median $8.32 Typical High $8.32 | Professional | 52 · Reduced service | $7.08 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $3.39 Typical High $3.39 | Professional | 53 · Discontinued | $2.82 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.72 Median $12.59 Typical High $12.59 | Professional | 54 · Surgery only | $10.72 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.51 Typical High $2.51 | Professional | 55 · Aftercare only | $2.14 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.66 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.45 | $1.66 | $1.66 |
Where Colorado sits
The same service costs 7.4 times more in Kansas 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· 15th of 51
$30.90
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.