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 $3,090.30 Median $5,495.41 Typical High $16,218.10 | Facility | None | $3,090.30 | $5,495.41 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $8,511.38 | Professional | None | $426.58 | $426.58 | $8,511.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $7,244.36 Typical High $13,182.57 | Facility | None | $4,786.30 | $7,244.36 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $870.96 | Professional | None | $416.87 | $549.54 | $870.96 |
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 $549.54 Median $630.96 Typical High $954.99 | Professional | None | $549.54 | $630.96 | $954.99 |
Denver HMP Setting Facility Modifier None Typical Low $426.58 Median $616.60 Typical High $954.99 | Facility | None | $426.58 | $616.60 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $724.44 | Professional | None | $331.13 | $489.78 | $724.44 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $691.83 Typical High $724.44 | Facility | None | $346.74 | $691.83 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $346.74 | Professional | None | $239.88 | $239.88 | $346.74 |
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 $575.44 Median $776.25 Typical High $1,174.90 | Professional | None | $575.44 | $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 $208.93 Median $213.80 Typical High $302.00 | Professional | 52 · Reduced service | $208.93 | $213.80 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $85.11 Typical High $120.23 | Professional | 53 · Discontinued | $83.18 | $85.11 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $323.59 Typical High $446.68 | Professional | 54 · Surgery only | $316.23 | $323.59 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $64.57 Typical High $89.13 | Professional | 55 · Aftercare only | $63.10 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $42.66 Typical High $60.26 | Professional | 56 · Pre-op care only | $41.69 | $42.66 | $60.26 |
Where Colorado sits
The same service costs 3.7 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
$1,096
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.