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 $72.44 Median $162.18 Typical High $371.54 | Professional | None | $72.44 | $162.18 | $371.54 |
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 $89.13 Median $186.21 Typical High $338.84 | Professional | None | $89.13 | $186.21 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $257.04 Typical High $1,659.59 | Facility | None | $151.36 | $257.04 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $138.04 Typical High $263.03 | Professional | None | $89.13 | $138.04 | $263.03 |
Denver HMP Setting Facility Modifier None Typical Low $72.44 Median $151.36 Typical High $239.88 | Facility | None | $72.44 | $151.36 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $141.25 Typical High $295.12 | Professional | None | $70.79 | $141.25 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $128.82 Median $181.97 Typical High $363.08 | Facility | None | $128.82 | $181.97 | $363.08 |
Select Health Setting Professional Modifier None Typical Low $44.67 Median $125.89 Typical High $338.84 | Professional | None | $44.67 | $125.89 | $338.84 |
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 $89.13 Median $147.91 Typical High $295.12 | Professional | None | $89.13 | $147.91 | $295.12 |
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 $36.31 Median $66.07 Typical High $83.18 | Professional | 52 · Reduced service | $36.31 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $26.30 Typical High $33.11 | Professional | 53 · Discontinued | $14.45 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $100.00 Typical High $125.89 | Professional | 54 · Surgery only | $54.95 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $19.95 Typical High $25.12 | Professional | 55 · Aftercare only | $10.96 | $19.95 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $13.18 Typical High $16.60 | Professional | 56 · Pre-op care only | $7.24 | $13.18 | $16.60 |
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· 7th of 51
$209
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.