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 $3,090.30 Median $6,918.31 Typical High $43,651.58 | Facility | None | $3,090.30 | $6,918.31 | $43,651.58 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $23,988.33 Typical High $23,988.33 | Professional | None | $691.83 | $23,988.33 | $23,988.33 |
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 $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $50,118.72 Typical High $57,543.99 | Facility | None | $1,513.56 | $50,118.72 | $57,543.99 |
Denver HMP Setting Facility Modifier None Typical Low $21,379.62 Median $23,988.33 Typical High $33,884.42 | Facility | None | $21,379.62 | $23,988.33 | $33,884.42 |
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 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $48,977.88 | Facility | None | $645.65 | $1,380.38 | $48,977.88 |
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 $346.74 Median $12,022.64 Typical High $12,022.64 | Professional | 52 · Reduced service | $346.74 | $12,022.64 | $12,022.64 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $4,786.30 Typical High $4,786.30 | Professional | 53 · Discontinued | $138.04 | $4,786.30 | $4,786.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $17,782.79 Typical High $17,782.79 | Professional | 54 · Surgery only | $512.86 | $17,782.79 | $17,782.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $3,630.78 Typical High $3,630.78 | Professional | 55 · Aftercare only | $102.33 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $2,398.83 Typical High $2,398.83 | Professional | 56 · Pre-op care only | $69.18 | $2,398.83 | $2,398.83 |
Where Colorado sits
The same service costs 6025.6 times more in Oklahoma than in Maine. 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· 13th of 51
$7,586
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.