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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $134.90 Typical High $177.83 | Professional | None | $74.13 | $134.90 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $194.98 Typical High $346.74 | Professional | None | $97.72 | $194.98 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $173.78 Typical High $331.13 | Professional | None | $89.13 | $173.78 | $331.13 |
Denver HMP Setting Facility Modifier None Typical Low $75.86 Median $162.18 Typical High $239.88 | Facility | None | $75.86 | $162.18 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $158.49 Typical High $323.59 | Professional | None | $79.43 | $158.49 | $323.59 |
Select Health Setting Facility Modifier None Typical Low $128.82 Median $165.96 Typical High $346.74 | Facility | None | $128.82 | $165.96 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $58.88 Median $109.65 Typical High $165.96 | Professional | None | $58.88 | $109.65 | $165.96 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $2,754.23 | Facility | None | $758.58 | $1,513.56 | $2,754.23 |
United Setting Professional Modifier None Typical Low $81.28 Median $169.82 Typical High $323.59 | Professional | None | $81.28 | $169.82 | $323.59 |
6 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 $37.15 Median $64.57 Typical High $83.18 | Professional | 52 · Reduced service | $37.15 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $25.70 Typical High $33.11 | Professional | 53 · Discontinued | $14.79 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $95.50 Typical High $125.89 | Professional | 54 · Surgery only | $54.95 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $19.50 Typical High $25.12 | Professional | 55 · Aftercare only | $11.22 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $12.88 Typical High $16.60 | Professional | 56 · Pre-op care only | $7.41 | $12.88 | $16.60 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $109.65 Median $204.17 Typical High $309.03 | Professional | 50 · Both sides | $109.65 | $204.17 | $309.03 |
Where Colorado sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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
$170
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.