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 $42.66 Median $79.43 Typical High $141.25 | Professional | None | $42.66 | $79.43 | $141.25 |
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 $52.48 Median $93.33 Typical High $158.49 | Professional | None | $52.48 | $93.33 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $72.44 Typical High $123.03 | Facility | None | $52.48 | $72.44 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $83.18 Typical High $128.82 | Professional | None | $50.12 | $83.18 | $128.82 |
Denver HMP Setting Facility Modifier None Typical Low $42.66 Median $79.43 Typical High $112.20 | Facility | None | $42.66 | $79.43 | $112.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $79.43 Typical High $138.04 | Professional | None | $41.69 | $79.43 | $138.04 |
Select Health Setting Facility Modifier None Typical Low $75.86 Median $83.18 Typical High $173.78 | Facility | None | $75.86 | $83.18 | $173.78 |
Select Health Setting Professional Modifier None Typical Low $26.30 Median $74.13 Typical High $158.49 | Professional | None | $26.30 | $74.13 | $158.49 |
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 $50.12 Median $85.11 Typical High $147.91 | Professional | None | $50.12 | $85.11 | $147.91 |
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 $20.89 Median $35.48 Typical High $39.81 | Professional | 52 · Reduced service | $20.89 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $14.13 Typical High $15.85 | Professional | 53 · Discontinued | $8.51 | $14.13 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $53.70 Typical High $58.88 | Professional | 54 · Surgery only | $31.62 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $10.72 Typical High $11.75 | Professional | 55 · Aftercare only | $6.31 | $10.72 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $7.08 Typical High $7.94 | Professional | 56 · Pre-op care only | $4.27 | $7.08 | $7.94 |
Where Colorado sits
The same service costs 3.2 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· 12th of 51
$100
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.