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 $1,445.44 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,445.44 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $1,288.25 Typical High $2,041.74 | Professional | None | $281.84 | $1,288.25 | $2,041.74 |
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 $316.23 Median $1,174.90 Typical High $2,754.23 | Professional | None | $316.23 | $1,174.90 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $1,071.52 Typical High $2,754.23 | Professional | None | $316.23 | $1,071.52 | $2,754.23 |
Denver HMP Setting Facility Modifier None Typical Low $281.84 Median $776.25 Typical High $2,089.30 | Facility | None | $281.84 | $776.25 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $870.96 Typical High $2,454.71 | Professional | None | $275.42 | $870.96 | $2,454.71 |
Select Health Setting Facility Modifier None Typical Low $446.68 Median $1,288.25 Typical High $2,691.53 | Facility | None | $446.68 | $1,288.25 | $2,691.53 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $380.19 Typical High $1,288.25 | Professional | None | $190.55 | $380.19 | $1,288.25 |
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 $309.03 Median $1,288.25 Typical High $2,754.23 | Professional | None | $309.03 | $1,288.25 | $2,754.23 |
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 $141.25 Median $575.44 Typical High $776.25 | Professional | 52 · Reduced service | $141.25 | $575.44 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $234.42 Typical High $309.03 | Professional | 53 · Discontinued | $56.23 | $234.42 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $870.96 Typical High $1,174.90 | Professional | 54 · Surgery only | $213.80 | $870.96 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $173.78 Typical High $234.42 | Professional | 55 · Aftercare only | $42.66 | $173.78 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $114.82 Typical High $154.88 | Professional | 56 · Pre-op care only | $28.18 | $114.82 | $154.88 |
Where Colorado sits
The same service costs 4.7 times more in Wisconsin than in Nebraska. 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· 10th of 51
$1,445
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.