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 $154.88 Median $1,548.82 Typical High $2,570.40 | Professional | None | $154.88 | $1,548.82 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $1,288.25 Typical High $2,951.21 | Professional | None | $181.97 | $1,288.25 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,819.70 Typical High $6,760.83 | Facility | None | $831.76 | $1,819.70 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $1,288.25 Typical High $2,754.23 | Professional | None | $194.98 | $1,288.25 | $2,754.23 |
Denver HMP Setting Facility Modifier None Typical Low $169.82 Median $457.09 Typical High $2,290.87 | Facility | None | $169.82 | $457.09 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $575.44 Typical High $2,398.83 | Professional | None | $138.04 | $575.44 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $263.03 Median $1,737.80 Typical High $2,951.21 | Facility | None | $263.03 | $1,737.80 | $2,951.21 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $1,412.54 | Professional | None | $91.20 | $91.20 | $1,412.54 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $208.93 Median $1,380.38 Typical High $3,090.30 | Professional | None | $208.93 | $1,380.38 | $3,090.30 |
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 $85.11 Median $602.56 Typical High $891.25 | Professional | 52 · Reduced service | $85.11 | $602.56 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $239.88 Typical High $354.81 | Professional | 53 · Discontinued | $33.88 | $239.88 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $912.01 Typical High $1,348.96 | Professional | 54 · Surgery only | $125.89 | $912.01 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $181.97 Typical High $269.15 | Professional | 55 · Aftercare only | $25.12 | $181.97 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $120.23 Typical High $177.83 | Professional | 56 · Pre-op care only | $16.98 | $120.23 | $177.83 |
Where Colorado sits
The same service costs 8.5 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· 6th of 51
$1,862
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.