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 $81.28 Median $141.25 Typical High $251.19 | Professional | None | $81.28 | $141.25 | $251.19 |
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 $100.00 Median $169.82 Typical High $288.40 | Professional | None | $100.00 | $169.82 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $524.81 Typical High $1,659.59 | Facility | None | $389.05 | $524.81 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $245.47 | Professional | None | $104.71 | $162.18 | $245.47 |
Denver HMP Setting Facility Modifier None Typical Low $81.28 Median $144.54 Typical High $234.42 | Facility | None | $81.28 | $144.54 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $144.54 Typical High $245.47 | Professional | None | $81.28 | $144.54 | $245.47 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $269.15 Typical High $512.86 | Facility | None | $144.54 | $269.15 | $512.86 |
Select Health Setting Professional Modifier None Typical Low $51.29 Median $144.54 Typical High $281.84 | Professional | None | $51.29 | $144.54 | $281.84 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,122.02 Typical High $2,884.03 | Facility | None | $489.78 | $1,122.02 | $2,884.03 |
United Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $269.15 | Professional | None | $100.00 | $158.49 | $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 $40.74 Median $64.57 Typical High $70.79 | Professional | 52 · Reduced service | $40.74 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $25.70 Typical High $28.18 | Professional | 53 · Discontinued | $16.22 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $97.72 Typical High $104.71 | Professional | 54 · Surgery only | $61.66 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $19.50 Typical High $20.89 | Professional | 55 · Aftercare only | $12.30 | $19.50 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $12.88 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.13 | $12.88 | $14.13 |
Where Colorado sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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· 14th of 51
$195
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.