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 $1,258.93 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $371.54 Typical High $1,258.93 | Professional | None | $165.96 | $371.54 | $1,258.93 |
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 $204.17 Median $446.68 Typical High $812.83 | Professional | None | $204.17 | $446.68 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $588.84 Typical High $2,187.76 | Facility | None | $398.11 | $588.84 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $371.54 Typical High $645.65 | Professional | None | $194.98 | $371.54 | $645.65 |
Denver HMP Setting Facility Modifier None Typical Low $165.96 Median $371.54 Typical High $616.60 | Facility | None | $165.96 | $371.54 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $323.59 Typical High $645.65 | Professional | None | $162.18 | $323.59 | $645.65 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $478.63 Typical High $794.33 | Facility | None | $295.12 | $478.63 | $794.33 |
Select Health Setting Professional Modifier None Typical Low $104.71 Median $288.40 Typical High $741.31 | Professional | None | $104.71 | $288.40 | $741.31 |
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 $199.53 Median $426.58 Typical High $758.58 | Professional | None | $199.53 | $426.58 | $758.58 |
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 $83.18 Median $169.82 Typical High $199.53 | Professional | 52 · Reduced service | $83.18 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $67.61 Typical High $79.43 | Professional | 53 · Discontinued | $33.88 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $251.19 Typical High $302.00 | Professional | 54 · Surgery only | $125.89 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $51.29 Typical High $60.26 | Professional | 55 · Aftercare only | $25.12 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $33.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $16.60 | $33.88 | $39.81 |
Where Colorado sits
The same service costs 2.8 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· 8th of 51
$525
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.