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 $2,570.40 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $257.04 Typical High $1,445.44 | Professional | None | $47.86 | $257.04 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.96 Median $33.11 Typical High $64.57 | Professional | None | $10.96 | $33.11 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,691.53 Typical High $2,691.53 | Facility | None | $758.58 | $2,691.53 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Denver HMP Setting Facility Modifier None Typical Low $234.42 Median $257.04 Typical High $371.54 | Facility | None | $234.42 | $257.04 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 |
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 $23.99 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $23.99 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $9.55 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $194.98 Typical High $194.98 | Professional | 54 · Surgery only | $36.31 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $7.24 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $4.79 | $25.70 | $25.70 |
Where Colorado sits
The same service costs 281.8 times more in North Dakota than in Vermont. 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· 46th of 51
$43.65
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.