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 $52.48 Median $117.49 Typical High $151.36 | Professional | None | $52.48 | $117.49 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $151.36 Typical High $269.15 | Professional | None | $66.07 | $151.36 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $123.03 Typical High $269.15 | Professional | None | $56.23 | $123.03 | $269.15 |
Denver HMP Setting Facility Modifier None Typical Low $52.48 Median $128.82 Typical High $302.00 | Facility | None | $52.48 | $128.82 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $117.49 Typical High $257.04 | Professional | None | $60.26 | $117.49 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $95.50 Median $134.90 Typical High $281.84 | Facility | None | $95.50 | $134.90 | $281.84 |
Select Health Setting Professional Modifier None Typical Low $39.81 Median $81.28 Typical High $134.90 | Professional | None | $39.81 | $81.28 | $134.90 |
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 $53.70 Median $120.23 Typical High $269.15 | Professional | None | $53.70 | $120.23 | $269.15 |
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 $26.30 Median $56.23 Typical High $70.79 | Professional | 52 · Reduced service | $26.30 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $22.39 Typical High $28.84 | Professional | 53 · Discontinued | $10.47 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $16.98 Typical High $21.38 | Professional | 55 · Aftercare only | $7.76 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $11.22 Typical High $14.13 | Professional | 56 · Pre-op care only | $5.25 | $11.22 | $14.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $77.62 Median $147.91 Typical High $512.86 | Professional | 50 · Both sides | $77.62 | $147.91 | $512.86 |
Where Colorado sits
The same service costs 2.7 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· 20th of 51
$132
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.