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 $120.23 Median $162.18 Typical High $3,801.89 | Facility | None | $120.23 | $162.18 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $3,801.89 Typical High $4,466.84 | Professional | None | $1,819.70 | $3,801.89 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,090.30 Median $4,466.84 Typical High $6,918.31 | Professional | None | $3,090.30 | $4,466.84 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $17,782.79 Median $17,782.79 Typical High $19,498.45 | Facility | None | $17,782.79 | $17,782.79 | $19,498.45 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,235.94 | Professional | None | $2,290.87 | $2,290.87 | $3,235.94 |
Denver HMP Setting Facility Modifier None Typical Low $2,238.72 Median $3,801.89 Typical High $5,370.32 | Facility | None | $2,238.72 | $3,801.89 | $5,370.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $4,466.84 | Professional | None | $2,137.96 | $3,311.31 | $4,466.84 |
Select Health Setting Facility Modifier None Typical Low $2,137.96 Median $3,981.07 Typical High $4,466.84 | Facility | None | $2,137.96 | $3,981.07 | $4,466.84 |
Select Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,137.96 Typical High $4,168.69 | Professional | None | $1,479.11 | $2,137.96 | $4,168.69 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $8,511.38 Typical High $16,218.10 | Facility | None | $3,981.07 | $8,511.38 | $16,218.10 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $3,311.31 Typical High $4,786.30 | Professional | None | $1,584.89 | $3,311.31 | $4,786.30 |
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 $912.01 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $912.01 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $363.08 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $2,818.38 Typical High $2,818.38 | Professional | 54 · Surgery only | $1,348.96 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $269.15 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $380.19 Typical High $380.19 | Professional | 56 · Pre-op care only | $181.97 | $380.19 | $380.19 |
Where Colorado sits
The same service costs 9.3 times more in Alaska than in Indiana. 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· 6th of 51
$3,981
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.