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 $1,258.93 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $436.52 | Professional | None | $158.49 | $281.84 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $331.13 Typical High $575.44 | Professional | None | $169.82 | $331.13 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $478.63 Typical High $2,187.76 | Facility | None | $275.42 | $478.63 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $467.74 | Professional | None | $162.18 | $275.42 | $467.74 |
Denver HMP Setting Facility Modifier None Typical Low $158.49 Median $309.03 Typical High $467.74 | Facility | None | $158.49 | $309.03 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $263.03 Typical High $478.63 | Professional | None | $128.82 | $263.03 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $331.13 Typical High $588.84 | Facility | None | $234.42 | $331.13 | $588.84 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $229.09 Typical High $549.54 | Professional | None | $83.18 | $229.09 | $549.54 |
United Setting Facility Modifier None Typical Low $239.88 Median $645.65 Typical High $1,905.46 | Facility | None | $239.88 | $645.65 | $1,905.46 |
United Setting Professional Modifier None Typical Low $162.18 Median $295.12 Typical High $512.86 | Professional | None | $162.18 | $295.12 | $512.86 |
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 $79.43 Median $125.89 Typical High $162.18 | Professional | 52 · Reduced service | $79.43 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $50.12 Typical High $64.57 | Professional | 53 · Discontinued | $31.62 | $50.12 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $190.55 Typical High $245.47 | Professional | 54 · Surgery only | $120.23 | $190.55 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $38.02 Typical High $48.98 | Professional | 55 · Aftercare only | $23.99 | $38.02 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $25.12 Typical High $32.36 | Professional | 56 · Pre-op care only | $15.85 | $25.12 | $32.36 |
Where Colorado sits
The same service costs 3.2 times more in Wisconsin than in Kentucky. 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· 10th of 51
$363
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.