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 $436.52 Median $489.78 Typical High $6,025.60 | Professional | None | $436.52 | $489.78 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $11,481.54 Typical High $18,620.87 | Facility | None | $7,585.78 | $11,481.54 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $977.24 | Professional | None | $446.68 | $588.84 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $794.33 | Professional | None | $489.78 | $630.96 | $794.33 |
Denver HMP Setting Facility Modifier None Typical Low $467.74 Median $489.78 Typical High $1,318.26 | Facility | None | $467.74 | $489.78 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $758.58 Typical High $1,122.02 | Professional | None | $501.19 | $758.58 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $1,071.52 Typical High $1,122.02 | Facility | None | $537.03 | $1,071.52 | $1,122.02 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $537.03 | Professional | None | $371.54 | $371.54 | $537.03 |
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 $436.52 Median $575.44 Typical High $933.25 | Professional | None | $436.52 | $575.44 | $933.25 |
3 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 54 · Surgery only Typical Low $331.13 Median $371.54 Typical High $436.52 | Professional | 54 · Surgery only | $331.13 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $74.13 Typical High $89.13 | Professional | 55 · Aftercare only | $66.07 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $48.98 Typical High $58.88 | Professional | 56 · Pre-op care only | $43.65 | $48.98 | $58.88 |
Where Colorado sits
The same service costs 7.1 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
$1,000
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.