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 $83.18 Median $3,162.28 Typical High $8,912.51 | Facility | None | $83.18 | $3,162.28 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $83.18 Typical High $144.54 | Professional | None | $53.70 | $83.18 | $144.54 |
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 $64.57 Median $104.71 Typical High $177.83 | Professional | None | $64.57 | $104.71 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,698.24 | Facility | None | $50.12 | $66.07 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $162.18 | Professional | None | $66.07 | $100.00 | $162.18 |
Denver HMP Setting Facility Modifier None Typical Low $53.70 Median $89.13 Typical High $177.83 | Facility | None | $53.70 | $89.13 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $85.11 Typical High $138.04 | Professional | None | $48.98 | $85.11 | $138.04 |
Select Health Setting Facility Modifier None Typical Low $81.28 Median $89.13 Typical High $169.82 | Facility | None | $81.28 | $89.13 | $169.82 |
Select Health Setting Professional Modifier None Typical Low $31.62 Median $81.28 Typical High $158.49 | Professional | None | $31.62 | $81.28 | $158.49 |
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 $64.57 Median $102.33 Typical High $186.21 | Professional | None | $64.57 | $102.33 | $186.21 |
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 $26.92 Median $35.48 Typical High $41.69 | Professional | 52 · Reduced service | $26.92 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $14.13 Typical High $16.60 | Professional | 53 · Discontinued | $10.72 | $14.13 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $53.70 Typical High $61.66 | Professional | 54 · Surgery only | $39.81 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.72 Typical High $12.30 | Professional | 55 · Aftercare only | $7.94 | $10.72 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.08 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.37 | $7.08 | $8.32 |
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· 17th of 51
$112
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.