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 $3,162.28 Median $8,511.38 Typical High $38,018.94 | Facility | None | $3,162.28 | $8,511.38 | $38,018.94 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $10,232.93 Typical High $10,232.93 | Professional | None | $676.08 | $10,232.93 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $9,549.93 Typical High $74,131.02 | Facility | None | $3,715.35 | $9,549.93 | $74,131.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $9,332.54 Median $12,022.64 Typical High $53,703.18 | Facility | None | $9,332.54 | $12,022.64 | $53,703.18 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Denver HMP Setting Facility Modifier None Typical Low $9,549.93 Median $10,232.93 Typical High $14,791.08 | Facility | None | $9,549.93 | $10,232.93 | $14,791.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10,232.93 Median $32,359.37 Typical High $37,153.52 | Professional | None | $10,232.93 | $32,359.37 | $37,153.52 |
Select Health Setting Facility Modifier None Typical Low $11,481.54 Median $11,481.54 Typical High $12,302.69 | Facility | None | $11,481.54 | $11,481.54 | $12,302.69 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $10,232.93 Typical High $50,118.72 | Facility | None | $4,570.88 | $10,232.93 | $50,118.72 |
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 $338.84 Median $5,128.61 Typical High $5,128.61 | Professional | 52 · Reduced service | $338.84 | $5,128.61 | $5,128.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $2,041.74 Typical High $2,041.74 | Professional | 53 · Discontinued | $134.90 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $7,762.47 Typical High $7,762.47 | Professional | 54 · Surgery only | $501.19 | $7,762.47 | $7,762.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $1,548.82 Typical High $1,548.82 | Professional | 55 · Aftercare only | $100.00 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $1,023.29 Typical High $1,023.29 | Professional | 56 · Pre-op care only | $67.61 | $1,023.29 | $1,023.29 |
Where Colorado sits
The same service costs 281.8 times more in Minnesota than in Montana. 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· 14th of 51
$10,000
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.