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 $1,258.93 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $524.81 Typical High $724.44 | Professional | None | $138.04 | $524.81 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $457.09 Typical High $1,202.26 | Professional | None | $154.88 | $457.09 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $467.74 Typical High $1,096.48 | Professional | None | $151.36 | $467.74 | $1,096.48 |
Denver HMP Setting Facility Modifier None Typical Low $138.04 Median $575.44 Typical High $912.01 | Facility | None | $138.04 | $575.44 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $380.19 Typical High $1,122.02 | Professional | None | $131.83 | $380.19 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $575.44 Typical High $1,202.26 | Facility | None | $213.80 | $575.44 | $1,202.26 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $181.97 Typical High $575.44 | Professional | None | $93.33 | $181.97 | $575.44 |
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 $144.54 Median $478.63 Typical High $1,071.52 | Professional | None | $144.54 | $478.63 | $1,071.52 |
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 $69.18 Median $208.93 Typical High $331.13 | Professional | 52 · Reduced service | $69.18 | $208.93 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $83.18 Typical High $131.83 | Professional | 53 · Discontinued | $27.54 | $83.18 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $309.03 Typical High $489.78 | Professional | 54 · Surgery only | $102.33 | $309.03 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $61.66 Typical High $100.00 | Professional | 55 · Aftercare only | $20.89 | $61.66 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $41.69 Typical High $66.07 | Professional | 56 · Pre-op care only | $13.80 | $41.69 | $66.07 |
Where Colorado sits
The same service costs 4.0 times more in Wisconsin than in Maryland. 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· 20th of 51
$525
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.