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 $53.70 Median $89.13 Typical High $147.91 | Professional | None | $53.70 | $89.13 | $147.91 |
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 $66.07 Median $107.15 Typical High $190.55 | Professional | None | $66.07 | $107.15 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,096.48 Typical High $1,659.59 | Facility | None | $407.38 | $1,096.48 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $147.91 | Professional | None | $66.07 | $97.72 | $147.91 |
Denver HMP Setting Facility Modifier None Typical Low $53.70 Median $89.13 Typical High $128.82 | Facility | None | $53.70 | $89.13 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $52.48 Median $93.33 Typical High $158.49 | Professional | None | $52.48 | $93.33 | $158.49 |
Select Health Setting Facility Modifier None Typical Low $93.33 Median $95.50 Typical High $194.98 | Facility | None | $93.33 | $95.50 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $33.88 Median $93.33 Typical High $181.97 | Professional | None | $33.88 | $93.33 | $181.97 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $64.57 Median $102.33 Typical High $169.82 | Professional | None | $64.57 | $102.33 | $169.82 |
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 $26.92 Median $40.74 Typical High $44.67 | Professional | 52 · Reduced service | $26.92 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $16.22 Typical High $17.78 | Professional | 53 · Discontinued | $10.96 | $16.22 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $61.66 Typical High $67.61 | Professional | 54 · Surgery only | $40.74 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $12.30 Typical High $13.49 | Professional | 55 · Aftercare only | $8.13 | $12.30 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $8.13 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.37 | $8.13 | $8.91 |
Where Colorado sits
The same service costs 3.5 times more in Wisconsin than in New York. 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
$117
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.