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 $147.91 Median $3,235.94 Typical High $8,912.51 | Facility | None | $147.91 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $147.91 Typical High $229.09 | Professional | None | $144.54 | $147.91 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $354.81 | Professional | None | $151.36 | $204.17 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $162.18 Typical High $218.78 | Professional | None | $131.83 | $162.18 | $218.78 |
Denver HMP Setting Facility Modifier None Typical Low $134.90 Median $173.78 Typical High $346.74 | Facility | None | $134.90 | $173.78 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $275.42 | Professional | None | $138.04 | $186.21 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $138.04 Median $257.04 Typical High $288.40 | Facility | None | $138.04 | $257.04 | $288.40 |
Select Health Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $190.55 | Professional | None | $95.50 | $138.04 | $190.55 |
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 $134.90 Median $165.96 Typical High $269.15 | Professional | None | $134.90 | $165.96 | $269.15 |
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 $70.79 Median $74.13 Typical High $75.86 | Professional | 52 · Reduced service | $70.79 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $29.51 Typical High $30.20 | Professional | 53 · Discontinued | $28.18 | $29.51 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $112.20 Typical High $114.82 | Professional | 54 · Surgery only | $104.71 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $22.39 Typical High $22.91 | Professional | 55 · Aftercare only | $20.89 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.79 Typical High $15.14 | Professional | 56 · Pre-op care only | $14.13 | $14.79 | $15.14 |
Where Colorado sits
The same service costs 3.2 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· 16th of 51
$195
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.