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 $10.47 Median $12.88 Typical High $37.15 | Facility | None | $10.47 | $12.88 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $21.38 Typical High $52.48 | Professional | None | $9.33 | $21.38 | $52.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.96 Median $32.36 Typical High $63.10 | Professional | None | $10.96 | $32.36 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,691.53 Typical High $2,691.53 | Facility | None | $758.58 | $2,691.53 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $25.12 Typical High $53.70 | Professional | None | $12.02 | $25.12 | $53.70 |
Denver HMP Setting Facility Modifier None Typical Low $10.47 Median $32.36 Typical High $52.48 | Facility | None | $10.47 | $32.36 | $52.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.51 Median $21.38 Typical High $54.95 | Professional | None | $8.51 | $21.38 | $54.95 |
Select Health Setting Facility Modifier None Typical Low $16.22 Median $33.11 Typical High $69.18 | Facility | None | $16.22 | $33.11 | $69.18 |
Select Health Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $33.11 | Professional | None | $5.62 | $5.62 | $33.11 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $11.75 Median $28.18 Typical High $61.66 | Professional | None | $11.75 | $28.18 | $61.66 |
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 $5.25 Median $7.76 Typical High $18.62 | Professional | 52 · Reduced service | $5.25 | $7.76 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $3.09 Typical High $7.41 | Professional | 53 · Discontinued | $2.04 | $3.09 | $7.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.76 Median $11.75 Typical High $27.54 | Professional | 54 · Surgery only | $7.76 | $11.75 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.55 Median $2.34 Typical High $5.50 | Professional | 55 · Aftercare only | $1.55 | $2.34 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.55 Typical High $3.72 | Professional | 56 · Pre-op care only | $1.05 | $1.55 | $3.72 |
Where Colorado sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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· 15th of 51
$33.88
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.