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 $302.00 Median $3,311.31 Typical High $8,709.64 | Facility | None | $302.00 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $208.93 Typical High $371.54 | Professional | None | $79.43 | $208.93 | $371.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $199.53 | Professional | None | $97.72 | $134.90 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $245.47 Typical High $588.84 | Professional | None | $91.20 | $245.47 | $588.84 |
Denver HMP Setting Facility Modifier None Typical Low $79.43 Median $302.00 Typical High $436.52 | Facility | None | $79.43 | $302.00 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $257.04 Typical High $660.69 | Professional | None | $87.10 | $257.04 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $138.04 Median $338.84 Typical High $724.44 | Facility | None | $138.04 | $338.84 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $117.49 Typical High $338.84 | Professional | None | $63.10 | $117.49 | $338.84 |
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 $89.13 Median $257.04 Typical High $562.34 | Professional | None | $89.13 | $257.04 | $562.34 |
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 $39.81 Median $87.10 Typical High $162.18 | Professional | 52 · Reduced service | $39.81 | $87.10 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $35.48 Typical High $64.57 | Professional | 53 · Discontinued | $15.85 | $35.48 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $131.83 Typical High $234.42 | Professional | 54 · Surgery only | $60.26 | $131.83 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $26.30 Typical High $47.86 | Professional | 55 · Aftercare only | $12.02 | $26.30 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $17.38 Typical High $32.36 | Professional | 56 · Pre-op care only | $7.94 | $17.38 | $32.36 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $263.03 Typical High $446.68 | Professional | 50 · Both sides | $117.49 | $263.03 | $446.68 |
Where Colorado sits
The same service costs 4.2 times more in Washington than in Virginia. 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· 43rd of 51
$162
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.