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 $30.90 Median $102.33 Typical High $177.83 | Professional | None | $30.90 | $102.33 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $107.15 Typical High $213.80 | Professional | None | $37.15 | $107.15 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $114.82 Typical High $208.93 | Facility | None | $52.48 | $114.82 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $95.50 Typical High $186.21 | Professional | None | $37.15 | $95.50 | $186.21 |
Denver HMP Setting Facility Modifier None Typical Low $30.90 Median $95.50 Typical High $154.88 | Facility | None | $30.90 | $95.50 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $32.36 Median $75.86 Typical High $177.83 | Professional | None | $32.36 | $75.86 | $177.83 |
Select Health Setting Facility Modifier None Typical Low $58.88 Median $138.04 Typical High $223.87 | Facility | None | $58.88 | $138.04 | $223.87 |
Select Health Setting Professional Modifier None Typical Low $20.42 Median $57.54 Typical High $208.93 | Professional | None | $20.42 | $57.54 | $208.93 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,995.26 | Facility | None | $239.88 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $38.02 Median $107.15 Typical High $199.53 | Professional | None | $38.02 | $107.15 | $199.53 |
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 $15.49 Median $45.71 Typical High $52.48 | Professional | 52 · Reduced service | $15.49 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $18.20 Typical High $20.89 | Professional | 53 · Discontinued | $6.17 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $67.61 Typical High $79.43 | Professional | 54 · Surgery only | $23.44 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $13.80 Typical High $15.85 | Professional | 55 · Aftercare only | $4.68 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $9.12 Typical High $10.47 | Professional | 56 · Pre-op care only | $3.09 | $9.12 | $10.47 |
Where Colorado sits
The same service costs 5.4 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· 10th of 51
$129
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.