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 $95.50 Median $3,235.94 Typical High $8,709.64 | Facility | None | $95.50 | $3,235.94 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $177.83 | Professional | None | $60.26 | $95.50 | $177.83 |
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 $81.28 Median $131.83 Typical High $234.42 | Professional | None | $81.28 | $131.83 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $128.82 Typical High $1,659.59 | Facility | None | $75.86 | $128.82 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $173.78 | Professional | None | $77.62 | $109.65 | $173.78 |
Denver HMP Setting Facility Modifier None Typical Low $60.26 Median $95.50 Typical High $144.54 | Facility | None | $60.26 | $95.50 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $112.20 Typical High $181.97 | Professional | None | $64.57 | $112.20 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $107.15 Typical High $223.87 | Facility | None | $91.20 | $107.15 | $223.87 |
Select Health Setting Professional Modifier None Typical Low $40.74 Median $107.15 Typical High $208.93 | Professional | None | $40.74 | $107.15 | $208.93 |
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 $77.62 Median $114.82 Typical High $204.17 | Professional | None | $77.62 | $114.82 | $204.17 |
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 $30.20 Median $44.67 Typical High $48.98 | Professional | 52 · Reduced service | $30.20 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $18.20 Typical High $19.50 | Professional | 53 · Discontinued | $12.02 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $67.61 Typical High $72.44 | Professional | 54 · Surgery only | $44.67 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $13.49 Typical High $14.79 | Professional | 55 · Aftercare only | $8.91 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.91 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.03 | $8.91 | $9.77 |
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· 12th of 51
$138
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.