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 $512.86 Median $1,000.00 Typical High $2,137.96 | Facility | None | $512.86 | $1,000.00 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $741.31 | Professional | None | $512.86 | $512.86 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $812.83 Typical High $1,445.44 | Facility | None | $549.54 | $812.83 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $575.44 Typical High $676.08 | Facility | None | $524.81 | $575.44 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Denver HMP Setting Facility Modifier None Typical Low $457.09 Median $512.86 Typical High $741.31 | Facility | None | $457.09 | $512.86 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $870.96 | Professional | None | $389.05 | $562.34 | $870.96 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $954.99 Typical High $1,071.52 | Facility | None | $512.86 | $954.99 | $1,071.52 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $512.86 | Professional | None | $363.08 | $363.08 | $512.86 |
United Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
United Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
4 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 $257.04 Median $257.04 Typical High $371.54 | Professional | 52 · Reduced service | $257.04 | $257.04 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $147.91 | Professional | 53 · Discontinued | $102.33 | $102.33 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $112.20 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $74.13 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $74.13 |
Where Colorado sits
The same service costs 1.6 times more in Arizona than in Nebraska. 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
$575
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.