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 $501.19 Median $512.86 Typical High $5,495.41 | Professional | None | $501.19 | $512.86 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $1,047.13 | Professional | None | $501.19 | $660.69 | $1,047.13 |
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 $575.44 Median $691.83 Typical High $933.25 | Professional | None | $575.44 | $691.83 | $933.25 |
Denver HMP Setting Facility Modifier None Typical Low $512.86 Median $562.34 Typical High $1,047.13 | Facility | None | $512.86 | $562.34 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $891.25 | Professional | None | $398.11 | $588.84 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $851.14 Typical High $891.25 | Facility | None | $416.87 | $851.14 | $891.25 |
Select Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $416.87 | Professional | None | $295.12 | $295.12 | $416.87 |
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 $616.60 Median $776.25 Typical High $1,174.90 | Professional | None | $616.60 | $776.25 | $1,174.90 |
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 $251.19 Median $257.04 Typical High $346.74 | Professional | 52 · Reduced service | $251.19 | $257.04 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $102.33 Typical High $138.04 | Professional | 53 · Discontinued | $100.00 | $102.33 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $524.81 | Professional | 54 · Surgery only | $371.54 | $389.05 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $104.71 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $51.29 Typical High $69.18 | Professional | 56 · Pre-op care only | $50.12 | $51.29 | $69.18 |
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· 5th of 51
$1,047
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.