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 $85.11 Median $3,235.94 Typical High $8,912.51 | Facility | None | $85.11 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $85.11 Typical High $151.36 | Professional | None | $52.48 | $85.11 | $151.36 |
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 $72.44 Median $117.49 Typical High $208.93 | Professional | None | $72.44 | $117.49 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $112.20 Typical High $1,659.59 | Facility | None | $64.57 | $112.20 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $154.88 | Professional | None | $69.18 | $100.00 | $154.88 |
Denver HMP Setting Facility Modifier None Typical Low $52.48 Median $87.10 Typical High $128.82 | Facility | None | $52.48 | $87.10 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $97.72 Typical High $162.18 | Professional | None | $53.70 | $97.72 | $162.18 |
Select Health Setting Facility Modifier None Typical Low $79.43 Median $95.50 Typical High $199.53 | Facility | None | $79.43 | $95.50 | $199.53 |
Select Health Setting Professional Modifier None Typical Low $34.67 Median $95.50 Typical High $186.21 | Professional | None | $34.67 | $95.50 | $186.21 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,862.09 | Facility | None | $239.88 | $616.60 | $1,862.09 |
United Setting Professional Modifier None Typical Low $70.79 Median $107.15 Typical High $177.83 | Professional | None | $70.79 | $107.15 | $177.83 |
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 $26.30 Median $39.81 Typical High $44.67 | Professional | 52 · Reduced service | $26.30 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $15.85 Typical High $18.20 | Professional | 53 · Discontinued | $10.47 | $15.85 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $60.26 Typical High $67.61 | Professional | 54 · Surgery only | $38.90 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $12.02 Typical High $13.49 | Professional | 55 · Aftercare only | $7.76 | $12.02 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $7.94 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.25 | $7.94 | $8.91 |
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· 10th of 51
$123
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.