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 $77.62 Median $3,235.94 Typical High $8,912.51 | Facility | None | $77.62 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $74.13 Typical High $97.72 | Professional | None | $40.74 | $74.13 | $97.72 |
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 $51.29 Median $91.20 Typical High $154.88 | Professional | None | $51.29 | $91.20 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,698.24 | Facility | None | $50.12 | $66.07 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $81.28 Typical High $128.82 | Professional | None | $48.98 | $81.28 | $128.82 |
Denver HMP Setting Facility Modifier None Typical Low $40.74 Median $77.62 Typical High $112.20 | Facility | None | $40.74 | $77.62 | $112.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $75.86 Typical High $138.04 | Professional | None | $39.81 | $75.86 | $138.04 |
Select Health Setting Facility Modifier None Typical Low $72.44 Median $81.28 Typical High $169.82 | Facility | None | $72.44 | $81.28 | $169.82 |
Select Health Setting Professional Modifier None Typical Low $25.70 Median $70.79 Typical High $158.49 | Professional | None | $25.70 | $70.79 | $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 $48.98 Median $83.18 Typical High $144.54 | Professional | None | $48.98 | $83.18 | $144.54 |
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 $20.42 Median $35.48 Typical High $38.90 | Professional | 52 · Reduced service | $20.42 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $14.13 Typical High $15.49 | Professional | 53 · Discontinued | $8.13 | $14.13 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $52.48 Typical High $58.88 | Professional | 54 · Surgery only | $30.90 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $10.47 Typical High $11.75 | Professional | 55 · Aftercare only | $6.17 | $10.47 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $7.08 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.07 | $7.08 | $7.76 |
Where Colorado sits
The same service costs 3.4 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· 10th 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.