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 $2,570.40 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $812.83 Typical High $5,495.41 | Professional | None | $794.33 | $812.83 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $11,481.54 Median $16,982.44 Typical High $38,904.51 | Facility | None | $11,481.54 | $16,982.44 | $38,904.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,659.59 | Professional | None | $794.33 | $1,047.13 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,137.96 Typical High $2,691.53 | Facility | None | $630.96 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,479.11 | Professional | None | $870.96 | $1,122.02 | $1,479.11 |
Denver HMP Setting Facility Modifier None Typical Low $812.83 Median $891.25 Typical High $1,659.59 | Facility | None | $812.83 | $891.25 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $1,380.38 | Professional | None | $630.96 | $933.25 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $1,318.26 Typical High $1,380.38 | Facility | None | $660.69 | $1,318.26 | $1,380.38 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $660.69 | Professional | None | $467.74 | $467.74 | $660.69 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,862.09 | Professional | None | $933.25 | $1,230.27 | $1,862.09 |
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 $398.11 Median $407.38 Typical High $549.54 | Professional | 52 · Reduced service | $398.11 | $407.38 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $162.18 Typical High $223.87 | Professional | 53 · Discontinued | $158.49 | $162.18 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $616.60 Typical High $831.76 | Professional | 54 · Surgery only | $588.84 | $616.60 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $165.96 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $81.28 Typical High $109.65 | Professional | 56 · Pre-op care only | $79.43 | $81.28 | $109.65 |
Where Colorado sits
The same service costs 3.8 times more in Wisconsin 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· 8th of 51
$1,445
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.