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 $93.33 Median $114.82 Typical High $144.54 | Facility | None | $93.33 | $114.82 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $93.33 Typical High $100.00 | Professional | None | $42.66 | $93.33 | $100.00 |
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 $83.18 Median $123.03 Typical High $204.17 | Professional | None | $83.18 | $123.03 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $53.70 Typical High $100.00 | Professional | None | $23.44 | $53.70 | $100.00 |
Denver HMP Setting Facility Modifier None Typical Low $43.65 Median $93.33 Typical High $131.83 | Facility | None | $43.65 | $93.33 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
United Setting Facility Modifier None Typical Low $870.96 Median $912.01 Typical High $1,047.13 | Facility | None | $870.96 | $912.01 | $1,047.13 |
United Setting Professional Modifier None Typical Low $34.67 Median $75.86 Typical High $85.11 | Professional | None | $34.67 | $75.86 | $85.11 |
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 $43.65 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $43.65 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $17.38 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $69.18 Typical High $69.18 | Professional | 54 · Surgery only | $64.57 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $12.88 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.71 | $9.33 | $9.33 |
Where Colorado sits
The same service costs 4.5 times more in Alaska than in Ohio. 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· 5th of 51
$123
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.