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 $275.42 Median $316.23 Typical High $467.74 | Professional | None | $275.42 | $316.23 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,715.19 Median $13,182.57 Typical High $24,547.09 | Facility | None | $10,715.19 | $13,182.57 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $630.96 | Professional | None | $302.00 | $398.11 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $2,691.53 | Facility | None | $645.65 | $2,290.87 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $562.34 | Professional | None | $323.59 | $426.58 | $562.34 |
Denver HMP Setting Facility Modifier None Typical Low $316.23 Median $398.11 Typical High $630.96 | Facility | None | $316.23 | $398.11 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $537.03 | Professional | None | $239.88 | $354.81 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $501.19 Typical High $537.03 | Facility | None | $251.19 | $501.19 | $537.03 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $251.19 | Professional | None | $177.83 | $177.83 | $251.19 |
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 $338.84 Median $436.52 Typical High $707.95 | Professional | None | $338.84 | $436.52 | $707.95 |
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 $151.36 Median $158.49 Typical High $213.80 | Professional | 52 · Reduced service | $151.36 | $158.49 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $63.10 Typical High $85.11 | Professional | 53 · Discontinued | $61.66 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $234.42 Typical High $316.23 | Professional | 54 · Surgery only | $229.09 | $234.42 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $47.86 Typical High $64.57 | Professional | 55 · Aftercare only | $45.71 | $47.86 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $42.66 | Professional | 56 · Pre-op care only | $30.90 | $31.62 | $42.66 |
Where Colorado sits
The same service costs 3.9 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· 3rd of 51
$759
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.