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 $407.38 Median $3,162.28 Typical High $8,912.51 | Facility | None | $407.38 | $3,162.28 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $831.76 Typical High $1,412.54 | Professional | None | $281.84 | $831.76 | $1,412.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $891.25 Typical High $1,778.28 | Professional | None | $309.03 | $891.25 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $776.25 Typical High $1,862.09 | Professional | None | $309.03 | $776.25 | $1,862.09 |
Denver HMP Setting Facility Modifier None Typical Low $281.84 Median $851.14 Typical High $1,862.09 | Facility | None | $281.84 | $851.14 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $562.34 Typical High $1,584.89 | Professional | None | $269.15 | $562.34 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $831.76 Typical High $1,737.80 | Facility | None | $436.52 | $831.76 | $1,737.80 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $371.54 Typical High $831.76 | Professional | None | $190.55 | $371.54 | $831.76 |
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 $295.12 Median $812.83 Typical High $1,819.70 | Professional | None | $295.12 | $812.83 | $1,819.70 |
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 $138.04 Median $380.19 Typical High $524.81 | Professional | 52 · Reduced service | $138.04 | $380.19 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $151.36 Typical High $208.93 | Professional | 53 · Discontinued | $56.23 | $151.36 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $562.34 Typical High $794.33 | Professional | 54 · Surgery only | $208.93 | $562.34 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $112.20 Typical High $158.49 | Professional | 55 · Aftercare only | $41.69 | $112.20 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $75.86 Typical High $104.71 | Professional | 56 · Pre-op care only | $28.18 | $75.86 | $104.71 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $1,202.26 Typical High $1,778.28 | Professional | 50 · Both sides | $398.11 | $1,202.26 | $1,778.28 |
Where Colorado sits
The same service costs 4.3 times more in Wisconsin than in Hawaii. 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· 18th of 51
$871
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.