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 $5,128.61 Median $5,128.61 Typical High $5,128.61 | Facility | None | $5,128.61 | $5,128.61 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,754.40 | Professional | None | $5,128.61 | $5,128.61 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,162.28 Median $5,495.41 Typical High $13,489.63 | Professional | None | $3,162.28 | $5,495.41 | $13,489.63 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,623.41 | Professional | None | $4,786.30 | $4,786.30 | $5,623.41 |
Denver HMP Setting Facility Modifier None Typical Low $5,128.61 Median $6,606.93 Typical High $12,302.69 | Facility | None | $5,128.61 | $6,606.93 | $12,302.69 |
Denver HMP Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Professional | None | $6,606.93 | $6,606.93 | $6,606.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7,413.10 Median $13,803.84 Typical High $19,952.62 | Professional | None | $7,413.10 | $13,803.84 | $19,952.62 |
Select Health Setting Facility Modifier None Typical Low $10,471.29 Median $19,498.45 Typical High $21,877.62 | Facility | None | $10,471.29 | $19,498.45 | $21,877.62 |
Select Health Setting Professional Modifier None Typical Low $7,413.10 Median $10,471.29 Typical High $13,182.57 | Professional | None | $7,413.10 | $10,471.29 | $13,182.57 |
United Setting Professional Modifier None Typical Low $4,265.80 Median $4,570.88 Typical High $7,079.46 | Professional | None | $4,265.80 | $4,570.88 | $7,079.46 |
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 $2,570.40 Median $2,570.40 Typical High $2,818.38 | Professional | 52 · Reduced service | $2,570.40 | $2,570.40 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,023.29 Median $1,023.29 Typical High $1,148.15 | Professional | 53 · Discontinued | $1,023.29 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $776.25 Median $776.25 Typical High $851.14 | Professional | 55 · Aftercare only | $776.25 | $776.25 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $512.86 Median $512.86 Typical High $575.44 | Professional | 56 · Pre-op care only | $512.86 | $512.86 | $575.44 |
Where Colorado sits
The same service costs 2.6 times more in Montana 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· 37th of 51
$5,129
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.