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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $512.86 Typical High $724.44 | Professional | None | $169.82 | $512.86 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $549.54 Typical High $1,202.26 | Professional | None | $190.55 | $549.54 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $478.63 Typical High $1,047.13 | Professional | None | $186.21 | $478.63 | $1,047.13 |
Denver HMP Setting Facility Modifier None Typical Low $169.82 Median $562.34 Typical High $891.25 | Facility | None | $169.82 | $562.34 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $363.08 Typical High $1,047.13 | Professional | None | $162.18 | $363.08 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $263.03 Median $537.03 Typical High $1,122.02 | Facility | None | $263.03 | $537.03 | $1,122.02 |
Select Health Setting Professional Modifier None Typical Low $114.82 Median $223.87 Typical High $537.03 | Professional | None | $114.82 | $223.87 | $537.03 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $2,754.23 | Facility | None | $758.58 | $1,513.56 | $2,754.23 |
United Setting Professional Modifier None Typical Low $177.83 Median $489.78 Typical High $1,047.13 | Professional | None | $177.83 | $489.78 | $1,047.13 |
6 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 $85.11 Median $229.09 Typical High $323.59 | Professional | 52 · Reduced service | $85.11 | $229.09 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $91.20 Typical High $128.82 | Professional | 53 · Discontinued | $33.88 | $91.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $338.84 Typical High $478.63 | Professional | 54 · Surgery only | $125.89 | $338.84 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $67.61 Typical High $95.50 | Professional | 55 · Aftercare only | $25.12 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $45.71 Typical High $64.57 | Professional | 56 · Pre-op care only | $16.98 | $45.71 | $64.57 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $234.42 Median $707.95 Typical High $933.25 | Professional | 50 · Both sides | $234.42 | $707.95 | $933.25 |
Where Colorado sits
The same service costs 3.5 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· 16th of 51
$537
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.