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 $323.59 Median $3,235.94 Typical High $8,912.51 | Facility | None | $323.59 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $741.31 Typical High $1,000.00 | Professional | None | $208.93 | $741.31 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $776.25 Typical High $1,778.28 | Professional | None | $263.03 | $776.25 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $660.69 Typical High $1,659.59 | Professional | None | $251.19 | $660.69 | $1,659.59 |
Denver HMP Setting Facility Modifier None Typical Low $208.93 Median $630.96 Typical High $1,202.26 | Facility | None | $208.93 | $630.96 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $575.44 Typical High $1,621.81 | Professional | None | $229.09 | $575.44 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $851.14 Typical High $1,778.28 | Facility | None | $363.08 | $851.14 | $1,778.28 |
Select Health Setting Professional Modifier None Typical Low $162.18 Median $309.03 Typical High $851.14 | Professional | None | $162.18 | $309.03 | $851.14 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $8,511.38 Typical High $16,595.87 | Facility | None | $3,981.07 | $8,511.38 | $16,595.87 |
United Setting Professional Modifier None Typical Low $245.47 Median $758.58 Typical High $1,621.81 | Professional | None | $245.47 | $758.58 | $1,621.81 |
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 $104.71 Median $338.84 Typical High $457.09 | Professional | 52 · Reduced service | $104.71 | $338.84 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $134.90 Typical High $181.97 | Professional | 53 · Discontinued | $41.69 | $134.90 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $501.19 Typical High $691.83 | Professional | 54 · Surgery only | $154.88 | $501.19 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $100.00 Typical High $138.04 | Professional | 55 · Aftercare only | $30.90 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $67.61 Typical High $91.20 | Professional | 56 · Pre-op care only | $20.89 | $67.61 | $91.20 |
Where Colorado sits
The same service costs 5.4 times more in Wisconsin than in Maryland. 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· 15th of 51
$871
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.