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 $1,412.54 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,412.54 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $1,202.26 Typical High $1,905.46 | Professional | None | $295.12 | $1,202.26 | $1,905.46 |
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 $354.81 Median $1,148.15 Typical High $2,570.40 | Professional | None | $354.81 | $1,148.15 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $1,071.52 Typical High $2,511.89 | Professional | None | $346.74 | $1,071.52 | $2,511.89 |
Denver HMP Setting Facility Modifier None Typical Low $316.23 Median $851.14 Typical High $2,041.74 | Facility | None | $316.23 | $851.14 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $891.25 Typical High $2,511.89 | Professional | None | $309.03 | $891.25 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $489.78 Median $1,318.26 Typical High $2,754.23 | Facility | None | $489.78 | $1,318.26 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $218.78 Median $416.87 Typical High $1,318.26 | Professional | None | $218.78 | $416.87 | $1,318.26 |
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 $331.13 Median $1,174.90 Typical High $2,570.40 | Professional | None | $331.13 | $1,174.90 | $2,570.40 |
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 $158.49 Median $512.86 Typical High $758.58 | Professional | 52 · Reduced service | $158.49 | $512.86 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $204.17 Typical High $302.00 | Professional | 53 · Discontinued | $64.57 | $204.17 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $758.58 Typical High $1,096.48 | Professional | 54 · Surgery only | $239.88 | $758.58 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $154.88 Typical High $229.09 | Professional | 55 · Aftercare only | $47.86 | $154.88 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $102.33 Typical High $151.36 | Professional | 56 · Pre-op care only | $31.62 | $102.33 | $151.36 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $1,698.24 Typical High $2,570.40 | Professional | 50 · Both sides | $436.52 | $1,698.24 | $2,570.40 |
Where Colorado sits
The same service costs 5.1 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· 13th of 51
$1,413
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.