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 $165.96 Median $3,235.94 Typical High $8,709.64 | Facility | None | $165.96 | $3,235.94 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $309.03 | Professional | None | $112.20 | $165.96 | $309.03 |
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 $151.36 Median $239.88 Typical High $407.38 | Professional | None | $151.36 | $239.88 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $213.80 Typical High $1,659.59 | Facility | None | $123.03 | $213.80 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $302.00 | Professional | None | $141.25 | $194.98 | $302.00 |
Denver HMP Setting Facility Modifier None Typical Low $112.20 Median $181.97 Typical High $251.19 | Facility | None | $112.20 | $181.97 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $316.23 | Professional | None | $120.23 | $199.53 | $316.23 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $186.21 Typical High $389.05 | Facility | None | $147.91 | $186.21 | $389.05 |
Select Health Setting Professional Modifier None Typical Low $75.86 Median $186.21 Typical High $363.08 | Professional | None | $75.86 | $186.21 | $363.08 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,174.90 Typical High $2,951.21 | Facility | None | $489.78 | $1,174.90 | $2,951.21 |
United Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $354.81 | Professional | None | $147.91 | $204.17 | $354.81 |
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 $56.23 Median $77.62 Typical High $87.10 | Professional | 52 · Reduced service | $56.23 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $31.62 Typical High $34.67 | Professional | 53 · Discontinued | $22.39 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $117.49 Typical High $128.82 | Professional | 54 · Surgery only | $83.18 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $23.44 Typical High $25.70 | Professional | 55 · Aftercare only | $16.60 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.49 Typical High $17.38 | Professional | 56 · Pre-op care only | $11.22 | $15.49 | $17.38 |
Where Colorado sits
The same service costs 3.7 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
$245
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.