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 $41.69 Median $123.03 Typical High $169.82 | Professional | None | $41.69 | $123.03 | $169.82 |
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 $50.12 Median $147.91 Typical High $331.13 | Professional | None | $50.12 | $147.91 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,698.24 | Facility | None | $50.12 | $66.07 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $97.72 Typical High $251.19 | Professional | None | $42.66 | $97.72 | $251.19 |
Denver HMP Setting Facility Modifier None Typical Low $41.69 Median $128.82 Typical High $234.42 | Facility | None | $41.69 | $128.82 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $47.86 Median $141.25 Typical High $302.00 | Professional | None | $47.86 | $141.25 | $302.00 |
Select Health Setting Facility Modifier None Typical Low $77.62 Median $177.83 Typical High $371.54 | Facility | None | $77.62 | $177.83 | $371.54 |
Select Health Setting Professional Modifier None Typical Low $33.88 Median $50.12 Typical High $177.83 | Professional | None | $33.88 | $50.12 | $177.83 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,174.90 Typical High $2,951.21 | Facility | None | $489.78 | $1,174.90 | $2,951.21 |
United Setting Professional Modifier None Typical Low $43.65 Median $117.49 Typical High $257.04 | Professional | None | $43.65 | $117.49 | $257.04 |
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 $20.89 Median $57.54 Typical High $83.18 | Professional | 52 · Reduced service | $20.89 | $57.54 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $22.91 Typical High $33.11 | Professional | 53 · Discontinued | $8.32 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $85.11 Typical High $123.03 | Professional | 54 · Surgery only | $30.90 | $85.11 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $16.98 Typical High $24.55 | Professional | 55 · Aftercare only | $6.17 | $16.98 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $11.48 Typical High $16.60 | Professional | 56 · Pre-op care only | $4.17 | $11.48 | $16.60 |
Where Colorado sits
The same service costs 4.6 times more in Wisconsin than in Washington, DC. 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· 17th of 51
$148
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.