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 $575.44 Median $3,235.94 Typical High $9,120.11 | Facility | None | $575.44 | $3,235.94 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $1,479.11 Typical High $2,344.23 | Professional | None | $309.03 | $1,479.11 | $2,344.23 |
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 $407.38 Median $1,412.54 Typical High $3,311.31 | Professional | None | $407.38 | $1,412.54 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $1,288.25 Typical High $3,090.30 | Professional | None | $371.54 | $1,288.25 | $3,090.30 |
Denver HMP Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $2,691.53 | Facility | None | $371.54 | $977.24 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $1,230.27 Typical High $3,548.13 | Professional | None | $363.08 | $1,230.27 | $3,548.13 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $1,862.09 Typical High $3,981.07 | Facility | None | $575.44 | $1,862.09 | $3,981.07 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $489.78 Typical High $1,862.09 | Professional | None | $251.19 | $489.78 | $1,862.09 |
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 $363.08 Median $1,445.44 Typical High $3,090.30 | Professional | None | $363.08 | $1,445.44 | $3,090.30 |
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 $186.21 Median $616.60 Typical High $933.25 | Professional | 52 · Reduced service | $186.21 | $616.60 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $245.47 Typical High $371.54 | Professional | 53 · Discontinued | $74.13 | $245.47 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $912.01 Typical High $1,412.54 | Professional | 54 · Surgery only | $275.42 | $912.01 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $186.21 Typical High $281.84 | Professional | 55 · Aftercare only | $54.95 | $186.21 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $123.03 Typical High $186.21 | Professional | 56 · Pre-op care only | $37.15 | $123.03 | $186.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $2,089.30 Typical High $2,754.23 | Professional | 50 · Both sides | $478.63 | $2,089.30 | $2,754.23 |
Where Colorado sits
The same service costs 5.6 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· 8th of 51
$1,820
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.