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 $2,570.40 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $8.32 Typical High $8.71 | Professional | None | $7.76 | $8.32 | $8.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.71 Median $11.48 Typical High $17.38 | Professional | None | $8.71 | $11.48 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $10.96 Typical High $18.20 | Professional | None | $9.33 | $10.96 | $18.20 |
Denver HMP Setting Facility Modifier None Typical Low $8.32 Median $10.72 Typical High $16.98 | Facility | None | $8.32 | $10.72 | $16.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.46 Median $8.91 Typical High $16.60 | Professional | None | $6.46 | $8.91 | $16.60 |
Select Health Setting Facility Modifier None Typical Low $8.13 Median $13.49 Typical High $16.98 | Facility | None | $8.13 | $13.49 | $16.98 |
Select Health Setting Professional Modifier None Typical Low $6.76 Median $8.13 Typical High $10.00 | Professional | None | $6.76 | $8.13 | $10.00 |
United Setting Facility Modifier None Typical Low $562.34 Median $588.84 Typical High $676.08 | Facility | None | $562.34 | $588.84 | $676.08 |
United Setting Professional Modifier None Typical Low $9.12 Median $11.48 Typical High $16.98 | Professional | None | $9.12 | $11.48 | $16.98 |
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 $3.80 Median $4.17 Typical High $4.17 | Professional | 52 · Reduced service | $3.80 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $1.66 Typical High $1.70 | Professional | 53 · Discontinued | $1.55 | $1.66 | $1.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.75 Median $6.31 Typical High $6.31 | Professional | 54 · Surgery only | $5.75 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.15 Median $1.26 Typical High $1.26 | Professional | 55 · Aftercare only | $1.15 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.83 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.78 | $0.83 | $0.83 |
Where Colorado sits
The same service costs 2.3 times more in Hawaii than in North Carolina. 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· 27th of 51
$10.96
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.