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 $89.13 Median $3,162.28 Typical High $7,762.47 | Facility | None | $89.13 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $93.33 Typical High $173.78 | Professional | None | $57.54 | $93.33 | $173.78 |
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 $79.43 Median $128.82 Typical High $223.87 | Professional | None | $79.43 | $128.82 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $70.79 Typical High $120.23 | Facility | None | $51.29 | $70.79 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $181.97 | Professional | None | $91.20 | $123.03 | $181.97 |
Denver HMP Setting Facility Modifier None Typical Low $57.54 Median $112.20 Typical High $154.88 | Facility | None | $57.54 | $112.20 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $107.15 Typical High $177.83 | Professional | None | $60.26 | $107.15 | $177.83 |
Select Health Setting Facility Modifier None Typical Low $81.28 Median $100.00 Typical High $208.93 | Facility | None | $81.28 | $100.00 | $208.93 |
Select Health Setting Professional Modifier None Typical Low $38.02 Median $100.00 Typical High $194.98 | Professional | None | $38.02 | $100.00 | $194.98 |
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 $85.11 Median $125.89 Typical High $199.53 | Professional | None | $85.11 | $125.89 | $199.53 |
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 $28.84 Median $45.71 Typical High $50.12 | Professional | 52 · Reduced service | $28.84 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $18.20 Typical High $19.95 | Professional | 53 · Discontinued | $11.48 | $18.20 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $67.61 Typical High $74.13 | Professional | 54 · Surgery only | $42.66 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $13.49 Typical High $14.79 | Professional | 55 · Aftercare only | $8.71 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $9.12 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.75 | $9.12 | $10.00 |
Where Colorado sits
The same service costs 3.0 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· 15th 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.