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 $141.25 Median $3,235.94 Typical High $8,709.64 | Facility | None | $141.25 | $3,235.94 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $257.04 | Professional | None | $91.20 | $141.25 | $257.04 |
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 $125.89 Median $204.17 Typical High $346.74 | Professional | None | $125.89 | $204.17 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $177.83 Typical High $1,659.59 | Facility | None | $102.33 | $177.83 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $257.04 | Professional | None | $120.23 | $165.96 | $257.04 |
Denver HMP Setting Facility Modifier None Typical Low $91.20 Median $151.36 Typical High $208.93 | Facility | None | $91.20 | $151.36 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $269.15 | Professional | None | $97.72 | $165.96 | $269.15 |
Select Health Setting Facility Modifier None Typical Low $123.03 Median $154.88 Typical High $323.59 | Facility | None | $123.03 | $154.88 | $323.59 |
Select Health Setting Professional Modifier None Typical Low $61.66 Median $154.88 Typical High $302.00 | Professional | None | $61.66 | $154.88 | $302.00 |
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 $123.03 Median $173.78 Typical High $302.00 | Professional | None | $123.03 | $173.78 | $302.00 |
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 $45.71 Median $66.07 Typical High $74.13 | Professional | 52 · Reduced service | $45.71 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $26.30 Typical High $29.51 | Professional | 53 · Discontinued | $18.20 | $26.30 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $100.00 Typical High $109.65 | Professional | 54 · Surgery only | $69.18 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.95 Typical High $21.88 | Professional | 55 · Aftercare only | $13.80 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $13.18 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.12 | $13.18 | $14.79 |
Where Colorado sits
The same service costs 3.2 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
$204
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.