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 $645.65 Median $3,235.94 Typical High $8,912.51 | Facility | None | $645.65 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $1,584.89 Typical High $3,162.28 | Professional | None | $354.81 | $1,584.89 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $1,737.80 Typical High $4,168.69 | Professional | None | $457.09 | $1,737.80 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $1,479.11 Typical High $3,981.07 | Professional | None | $416.87 | $1,479.11 | $3,981.07 |
Denver HMP Setting Facility Modifier None Typical Low $416.87 Median $1,096.48 Typical High $3,311.31 | Facility | None | $416.87 | $1,096.48 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $1,548.82 Typical High $4,677.35 | Professional | None | $398.11 | $1,548.82 | $4,677.35 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $2,398.83 Typical High $5,011.87 | Facility | None | $645.65 | $2,398.83 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $549.54 Typical High $2,398.83 | Professional | None | $281.84 | $549.54 | $2,398.83 |
United Setting Facility Modifier None Typical Low $10,715.19 Median $14,125.38 Typical High $25,703.96 | Facility | None | $10,715.19 | $14,125.38 | $25,703.96 |
United Setting Professional Modifier None Typical Low $407.38 Median $1,737.80 Typical High $3,801.89 | Professional | None | $407.38 | $1,737.80 | $3,801.89 |
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 $208.93 Median $724.44 Typical High $1,174.90 | Professional | 52 · Reduced service | $208.93 | $724.44 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $295.12 Typical High $467.74 | Professional | 53 · Discontinued | $83.18 | $295.12 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $1,096.48 Typical High $1,737.80 | Professional | 54 · Surgery only | $309.03 | $1,096.48 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $218.78 Typical High $346.74 | Professional | 55 · Aftercare only | $61.66 | $218.78 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $147.91 Typical High $234.42 | Professional | 56 · Pre-op care only | $41.69 | $147.91 | $234.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $2,570.40 Typical High $3,548.13 | Professional | 50 · Both sides | $537.03 | $2,570.40 | $3,548.13 |
Where Colorado sits
The same service costs 6.2 times more in Washington 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· 6th of 51
$2,188
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.