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 $7,413.10 Typical High $38,018.94 | Facility | None | $3,162.28 | $7,413.10 | $38,018.94 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $16,595.87 Typical High $16,595.87 | Professional | None | $912.01 | $16,595.87 | $16,595.87 |
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 $15,488.17 Median $20,417.38 Typical High $53,703.18 | Facility | None | $15,488.17 | $20,417.38 | $53,703.18 |
Denver HMP Setting Facility Modifier None Typical Low $14,791.08 Median $16,595.87 Typical High $23,442.29 | Facility | None | $14,791.08 | $16,595.87 | $23,442.29 |
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 $19,952.62 Median $19,952.62 Typical High $21,379.62 | Facility | None | $19,952.62 | $19,952.62 | $21,379.62 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $10,000.00 Typical High $50,118.72 | Facility | None | $4,570.88 | $10,000.00 | $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 $457.09 Median $8,317.64 Typical High $8,317.64 | Professional | 52 · Reduced service | $457.09 | $8,317.64 | $8,317.64 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $3,311.31 Typical High $3,311.31 | Professional | 53 · Discontinued | $181.97 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $12,302.69 Typical High $12,302.69 | Professional | 54 · Surgery only | $691.83 | $12,302.69 | $12,302.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $2,454.71 Typical High $2,454.71 | Professional | 55 · Aftercare only | $138.04 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $1,659.59 Typical High $1,659.59 | Professional | 56 · Pre-op care only | $91.20 | $1,659.59 | $1,659.59 |
Where Colorado sits
The same service costs 5754.4 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· 26th of 51
$10,233
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.