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 $57.54 Median $3,162.28 Typical High $7,762.47 | Facility | None | $57.54 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $141.25 Typical High $281.84 | Professional | None | $36.31 | $141.25 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $138.04 Typical High $389.05 | Professional | None | $47.86 | $138.04 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $131.83 Typical High $338.84 | Professional | None | $45.71 | $131.83 | $338.84 |
Denver HMP Setting Facility Modifier None Typical Low $36.31 Median $162.18 Typical High $257.04 | Facility | None | $36.31 | $162.18 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $134.90 Typical High $346.74 | Professional | None | $39.81 | $134.90 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $64.57 Median $181.97 Typical High $380.19 | Facility | None | $64.57 | $181.97 | $380.19 |
Select Health Setting Professional Modifier None Typical Low $28.18 Median $54.95 Typical High $181.97 | Professional | None | $28.18 | $54.95 | $181.97 |
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 $41.69 Median $138.04 Typical High $323.59 | Professional | None | $41.69 | $138.04 | $323.59 |
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 $18.20 Median $58.88 Typical High $97.72 | Professional | 52 · Reduced service | $18.20 | $58.88 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $23.44 Typical High $39.81 | Professional | 53 · Discontinued | $7.24 | $23.44 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $87.10 Typical High $147.91 | Professional | 54 · Surgery only | $27.54 | $87.10 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $17.38 Typical High $29.51 | Professional | 55 · Aftercare only | $5.50 | $17.38 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $11.75 Typical High $19.50 | Professional | 56 · Pre-op care only | $3.63 | $11.75 | $19.50 |
Where Colorado sits
The same service costs 4.5 times more in Wisconsin than in Michigan. 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· 26th 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.