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 $181.97 Median $3,090.30 Typical High $8,912.51 | Facility | None | $181.97 | $3,090.30 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $331.13 | Professional | None | $138.04 | $213.80 | $331.13 |
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 $151.36 Median $251.19 Typical High $436.52 | Professional | None | $151.36 | $251.19 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $281.84 Typical High $1,659.59 | Facility | None | $162.18 | $281.84 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $346.74 | Professional | None | $154.88 | $234.42 | $346.74 |
Denver HMP Setting Facility Modifier None Typical Low $141.25 Median $234.42 Typical High $338.84 | Facility | None | $141.25 | $234.42 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $346.74 | Professional | None | $114.82 | $208.93 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $208.93 Typical High $426.58 | Facility | None | $194.98 | $208.93 | $426.58 |
Select Health Setting Professional Modifier None Typical Low $74.13 Median $204.17 Typical High $398.11 | Professional | None | $74.13 | $204.17 | $398.11 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $389.05 | Professional | None | $154.88 | $234.42 | $389.05 |
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 $70.79 Median $95.50 Typical High $117.49 | Professional | 52 · Reduced service | $70.79 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $38.02 Typical High $46.77 | Professional | 53 · Discontinued | $28.18 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $144.54 Typical High $177.83 | Professional | 54 · Surgery only | $107.15 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $28.84 Typical High $35.48 | Professional | 55 · Aftercare only | $21.38 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $19.05 Typical High $23.44 | Professional | 56 · Pre-op care only | $14.13 | $19.05 | $23.44 |
Where Colorado sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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· 13th of 51
$269
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.