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 $100.00 Median $3,235.94 Typical High $8,912.51 | Facility | None | $100.00 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $151.36 | Professional | None | $60.26 | $93.33 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $104.71 Typical High $177.83 | Professional | None | $64.57 | $104.71 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,691.53 Typical High $2,691.53 | Facility | None | $758.58 | $2,691.53 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $109.65 Typical High $154.88 | Professional | None | $70.79 | $109.65 | $154.88 |
Denver HMP Setting Facility Modifier None Typical Low $60.26 Median $100.00 Typical High $204.17 | Facility | None | $60.26 | $100.00 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $47.86 Median $89.13 Typical High $158.49 | Professional | None | $47.86 | $89.13 | $158.49 |
Select Health Setting Facility Modifier None Typical Low $89.13 Median $91.20 Typical High $186.21 | Facility | None | $89.13 | $91.20 | $186.21 |
Select Health Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $89.13 | Professional | None | $31.62 | $31.62 | $89.13 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $72.44 Median $117.49 Typical High $190.55 | Professional | None | $72.44 | $117.49 | $190.55 |
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 $30.20 Median $43.65 Typical High $50.12 | Professional | 52 · Reduced service | $30.20 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $17.38 Typical High $19.95 | Professional | 53 · Discontinued | $12.02 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $66.07 Typical High $75.86 | Professional | 54 · Surgery only | $44.67 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $13.18 Typical High $15.14 | Professional | 55 · Aftercare only | $8.91 | $13.18 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.71 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.03 | $8.71 | $10.00 |
Where Colorado sits
The same service costs 3.7 times more in Wisconsin than in Florida. 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· 20th of 51
$115
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.