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 $60.26 Median $3,235.94 Typical High $8,709.64 | Facility | None | $60.26 | $3,235.94 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $95.50 | Professional | None | $54.95 | $60.26 | $95.50 |
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 $51.29 Median $67.61 Typical High $114.82 | Professional | None | $51.29 | $67.61 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $56.23 Typical High $1,659.59 | Facility | None | $32.36 | $56.23 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $85.11 Typical High $123.03 | Professional | None | $53.70 | $85.11 | $123.03 |
Denver HMP Setting Facility Modifier None Typical Low $54.95 Median $79.43 Typical High $128.82 | Facility | None | $54.95 | $79.43 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $42.66 Median $63.10 Typical High $81.28 | Professional | None | $42.66 | $63.10 | $81.28 |
Select Health Setting Facility Modifier None Typical Low $39.81 Median $53.70 Typical High $112.20 | Facility | None | $39.81 | $53.70 | $112.20 |
Select Health Setting Professional Modifier None Typical Low $27.54 Median $47.86 Typical High $56.23 | Professional | None | $27.54 | $47.86 | $56.23 |
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 $66.07 Median $91.20 Typical High $151.36 | Professional | None | $66.07 | $91.20 | $151.36 |
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 $27.54 Median $30.20 Typical High $33.88 | Professional | 52 · Reduced service | $27.54 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $12.02 Typical High $13.49 | Professional | 53 · Discontinued | $10.96 | $12.02 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $45.71 Typical High $51.29 | Professional | 54 · Surgery only | $41.69 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $9.12 Typical High $10.23 | Professional | 55 · Aftercare only | $8.32 | $9.12 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.03 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.50 | $6.03 | $6.76 |
Where Colorado sits
The same service costs 3.6 times more in Wyoming than in Florida. 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· 17th of 51
$91.20
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.