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 $371.54 Median $407.38 Typical High $407.38 | Professional | None | $371.54 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,570.88 Typical High $7,079.46 | Facility | None | $758.58 | $4,570.88 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Denver HMP Setting Facility Modifier None Typical Low $331.13 Median $407.38 Typical High $575.44 | Facility | None | $331.13 | $407.38 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $691.83 | Professional | None | $363.08 | $478.63 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $724.44 Typical High $6,165.95 | Facility | None | $363.08 | $724.44 | $6,165.95 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $371.54 Typical High $549.54 | Professional | None | $354.81 | $371.54 | $549.54 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $794.33 | Professional | None | $398.11 | $524.81 | $794.33 |
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 $186.21 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $186.21 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $74.13 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $281.84 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $37.15 | $40.74 | $40.74 |
Where Colorado sits
The same service costs 4.5 times more in Alaska than in New York. 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· 18th of 51
$513
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.