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 $1,513.56 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,513.56 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $1,995.26 Typical High $3,090.30 | Professional | None | $398.11 | $1,995.26 | $3,090.30 |
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 $446.68 Median $1,862.09 Typical High $4,265.80 | Professional | None | $446.68 | $1,862.09 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $1,348.96 Typical High $4,365.16 | Professional | None | $436.52 | $1,348.96 | $4,365.16 |
Denver HMP Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $3,311.31 | Facility | None | $398.11 | $1,071.52 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $1,348.96 Typical High $3,801.89 | Professional | None | $380.19 | $1,348.96 | $3,801.89 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $4,168.69 | Facility | None | $602.56 | $1,995.26 | $4,168.69 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $512.86 Typical High $1,995.26 | Professional | None | $269.15 | $512.86 | $1,995.26 |
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 $426.58 Median $1,995.26 Typical High $4,265.80 | Professional | None | $426.58 | $1,995.26 | $4,265.80 |
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 $199.53 Median $912.01 Typical High $1,230.27 | Professional | 52 · Reduced service | $199.53 | $912.01 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $363.08 Typical High $489.78 | Professional | 53 · Discontinued | $79.43 | $363.08 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $1,380.38 Typical High $1,819.70 | Professional | 54 · Surgery only | $295.12 | $1,380.38 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $275.42 Typical High $363.08 | Professional | 55 · Aftercare only | $58.88 | $275.42 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $181.97 Typical High $245.47 | Professional | 56 · Pre-op care only | $39.81 | $181.97 | $245.47 |
Where Colorado sits
The same service costs 6.9 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· 12th of 51
$2,291
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.