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 $3,388.44 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,388.44 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $1,000.00 Typical High $1,513.56 | Professional | None | $218.78 | $1,000.00 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $870.96 Typical High $2,089.30 | Professional | None | $245.47 | $870.96 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $831.76 Typical High $2,089.30 | Professional | None | $245.47 | $831.76 | $2,089.30 |
Denver HMP Setting Facility Modifier None Typical Low $223.87 Median $602.56 Typical High $1,584.89 | Facility | None | $223.87 | $602.56 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $676.08 Typical High $1,905.46 | Professional | None | $218.78 | $676.08 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $1,000.00 Typical High $2,089.30 | Facility | None | $346.74 | $1,000.00 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $295.12 Typical High $1,000.00 | Professional | None | $151.36 | $295.12 | $1,000.00 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $8,511.38 Typical High $16,595.87 | Facility | None | $3,981.07 | $8,511.38 | $16,595.87 |
United Setting Professional Modifier None Typical Low $239.88 Median $977.24 Typical High $2,089.30 | Professional | None | $239.88 | $977.24 | $2,089.30 |
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 $109.65 Median $436.52 Typical High $602.56 | Professional | 52 · Reduced service | $109.65 | $436.52 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $173.78 Typical High $239.88 | Professional | 53 · Discontinued | $44.67 | $173.78 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $645.65 Typical High $891.25 | Professional | 54 · Surgery only | $165.96 | $645.65 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $128.82 Typical High $181.97 | Professional | 55 · Aftercare only | $33.11 | $128.82 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $87.10 Typical High $120.23 | Professional | 56 · Pre-op care only | $22.39 | $87.10 | $120.23 |
Where Colorado sits
The same service costs 5.9 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· 11th of 51
$1,122
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.