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 $741.31 Median $3,235.94 Typical High $8,912.51 | Facility | None | $741.31 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $173.78 Typical High $741.31 | Professional | None | $93.33 | $173.78 | $741.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $331.13 Typical High $1,479.11 | Professional | None | $109.65 | $331.13 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $208.93 Typical High $1,071.52 | Professional | None | $100.00 | $208.93 | $1,071.52 |
Denver HMP Setting Facility Modifier None Typical Low $100.00 Median $229.09 Typical High $1,047.13 | Facility | None | $100.00 | $229.09 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $354.81 Typical High $1,380.38 | Professional | None | $91.20 | $354.81 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $758.58 Typical High $1,584.89 | Facility | None | $154.88 | $758.58 | $1,584.89 |
Select Health Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $758.58 | Professional | None | $70.79 | $102.33 | $758.58 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $4,677.35 Typical High $13,182.57 | Facility | None | $2,570.40 | $4,677.35 | $13,182.57 |
United Setting Professional Modifier None Typical Low $104.71 Median $213.80 Typical High $977.24 | Professional | None | $104.71 | $213.80 | $977.24 |
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 $46.77 Median $87.10 Typical High $371.54 | Professional | 52 · Reduced service | $46.77 | $87.10 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $34.67 Typical High $147.91 | Professional | 53 · Discontinued | $18.62 | $34.67 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $131.83 Typical High $562.34 | Professional | 54 · Surgery only | $70.79 | $131.83 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $26.30 Typical High $112.20 | Professional | 55 · Aftercare only | $14.13 | $26.30 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $17.38 Typical High $74.13 | Professional | 56 · Pre-op care only | $9.33 | $17.38 | $74.13 |
Where Colorado sits
The same service costs 9.5 times more in Washington than in Washington, DC. 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
$245
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.