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 $123.03 Median $3,235.94 Typical High $7,762.47 | Facility | None | $123.03 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $234.42 | Professional | None | $83.18 | $123.03 | $234.42 |
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 $112.20 Median $177.83 Typical High $302.00 | Professional | None | $112.20 | $177.83 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $165.96 Typical High $1,659.59 | Facility | None | $95.50 | $165.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $223.87 | Professional | None | $104.71 | $147.91 | $223.87 |
Denver HMP Setting Facility Modifier None Typical Low $83.18 Median $123.03 Typical High $190.55 | Facility | None | $83.18 | $123.03 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $147.91 Typical High $239.88 | Professional | None | $89.13 | $147.91 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $141.25 Typical High $295.12 | Facility | None | $117.49 | $141.25 | $295.12 |
Select Health Setting Professional Modifier None Typical Low $56.23 Median $141.25 Typical High $275.42 | Professional | None | $56.23 | $141.25 | $275.42 |
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 $107.15 Median $151.36 Typical High $263.03 | Professional | None | $107.15 | $151.36 | $263.03 |
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 $41.69 Median $58.88 Typical High $64.57 | Professional | 52 · Reduced service | $41.69 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $23.44 Typical High $25.70 | Professional | 53 · Discontinued | $16.60 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $87.10 Typical High $97.72 | Professional | 54 · Surgery only | $61.66 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $17.38 Typical High $19.50 | Professional | 55 · Aftercare only | $12.30 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $11.75 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.32 | $11.75 | $12.88 |
Where Colorado sits
The same service costs 3.3 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· 11th of 51
$182
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.