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 $66.07 Median $3,162.28 Typical High $8,912.51 | Facility | None | $66.07 | $3,162.28 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $69.18 Typical High $114.82 | Professional | None | $41.69 | $69.18 | $114.82 |
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 $57.54 Median $93.33 Typical High $165.96 | Professional | None | $57.54 | $93.33 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $60.26 Typical High $95.50 | Facility | None | $46.77 | $60.26 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $83.18 Typical High $125.89 | Professional | None | $54.95 | $83.18 | $125.89 |
Denver HMP Setting Facility Modifier None Typical Low $41.69 Median $69.18 Typical High $107.15 | Facility | None | $41.69 | $69.18 | $107.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $75.86 Typical High $125.89 | Professional | None | $43.65 | $75.86 | $125.89 |
Select Health Setting Facility Modifier None Typical Low $56.23 Median $72.44 Typical High $151.36 | Facility | None | $56.23 | $72.44 | $151.36 |
Select Health Setting Professional Modifier None Typical Low $28.18 Median $72.44 Typical High $141.25 | Professional | None | $28.18 | $72.44 | $141.25 |
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 $56.23 Median $87.10 Typical High $144.54 | Professional | None | $56.23 | $87.10 | $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 $20.89 Median $32.36 Typical High $34.67 | Professional | 52 · Reduced service | $20.89 | $32.36 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $12.88 Typical High $13.80 | Professional | 53 · Discontinued | $8.32 | $12.88 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $48.98 Typical High $52.48 | Professional | 54 · Surgery only | $31.62 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $9.77 Typical High $10.47 | Professional | 55 · Aftercare only | $6.31 | $9.77 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.46 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.17 | $6.46 | $6.92 |
Where Colorado sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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
$97.72
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.