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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $173.78 Typical High $281.84 | Professional | None | $77.62 | $173.78 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $194.98 Typical High $346.74 | Professional | None | $85.11 | $194.98 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $186.21 Typical High $363.08 | Professional | None | $83.18 | $186.21 | $363.08 |
Denver HMP Setting Facility Modifier None Typical Low $79.43 Median $177.83 Typical High $281.84 | Facility | None | $79.43 | $177.83 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $158.49 Typical High $309.03 | Professional | None | $74.13 | $158.49 | $309.03 |
Select Health Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $371.54 | Facility | None | $123.03 | $173.78 | $371.54 |
Select Health Setting Professional Modifier None Typical Low $56.23 Median $91.20 Typical High $173.78 | Professional | None | $56.23 | $91.20 | $173.78 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $2,754.23 | Facility | None | $758.58 | $1,513.56 | $2,754.23 |
United Setting Professional Modifier None Typical Low $85.11 Median $186.21 Typical High $363.08 | Professional | None | $85.11 | $186.21 | $363.08 |
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 $39.81 Median $83.18 Typical High $104.71 | Professional | 52 · Reduced service | $39.81 | $83.18 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $33.11 Typical High $42.66 | Professional | 53 · Discontinued | $15.85 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $123.03 Typical High $158.49 | Professional | 54 · Surgery only | $58.88 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $24.55 Typical High $31.62 | Professional | 55 · Aftercare only | $11.75 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $16.60 Typical High $21.38 | Professional | 56 · Pre-op care only | $7.94 | $16.60 | $21.38 |
Where Colorado sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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
$191
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.