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 $16.98 Median $32.36 Typical High $58.88 | Facility | None | $16.98 | $32.36 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $29.51 Typical High $36.31 | Professional | None | $15.85 | $29.51 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,290.87 Median $3,548.13 Typical High $9,120.11 | Facility | None | $2,290.87 | $3,548.13 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.96 Median $26.30 Typical High $56.23 | Professional | None | $10.96 | $26.30 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,621.81 | Facility | None | $50.12 | $66.07 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $31.62 Typical High $48.98 | Professional | None | $19.50 | $31.62 | $48.98 |
Denver HMP Setting Facility Modifier None Typical Low $15.85 Median $28.84 Typical High $45.71 | Facility | None | $15.85 | $28.84 | $45.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $14.45 Median $26.92 Typical High $52.48 | Professional | None | $14.45 | $26.92 | $52.48 |
Select Health Setting Facility Modifier None Typical Low $26.30 Median $28.18 Typical High $60.26 | Facility | None | $26.30 | $28.18 | $60.26 |
Select Health Setting Professional Modifier None Typical Low $9.12 Median $15.14 Typical High $28.18 | Professional | None | $9.12 | $15.14 | $28.18 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $2,041.74 | Facility | None | $239.88 | $616.60 | $2,041.74 |
United Setting Professional Modifier None Typical Low $18.20 Median $31.62 Typical High $58.88 | Professional | None | $18.20 | $31.62 | $58.88 |
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 $8.51 Median $13.49 Typical High $17.38 | Professional | 52 · Reduced service | $8.51 | $13.49 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $5.37 Typical High $6.92 | Professional | 53 · Discontinued | $3.39 | $5.37 | $6.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.59 Median $20.42 Typical High $25.70 | Professional | 54 · Surgery only | $12.59 | $20.42 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $4.07 Typical High $5.13 | Professional | 55 · Aftercare only | $2.51 | $4.07 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $2.69 Typical High $3.47 | Professional | 56 · Pre-op care only | $1.70 | $2.69 | $3.47 |
Where Colorado sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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· 23rd of 51
$35.48
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.