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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $354.81 Typical High $954.99 | Professional | None | $199.53 | $354.81 | $954.99 |
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 $229.09 Median $446.68 Typical High $812.83 | Professional | None | $229.09 | $446.68 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,148.15 Typical High $1,659.59 | Facility | None | $512.86 | $1,148.15 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Denver HMP Setting Facility Modifier None Typical Low $181.97 Median $288.40 Typical High $524.81 | Facility | None | $181.97 | $288.40 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $562.34 | Professional | None | $173.78 | $323.59 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $316.23 Median $323.59 Typical High $691.83 | Facility | None | $316.23 | $323.59 | $691.83 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $309.03 Typical High $630.96 | Professional | None | $112.20 | $309.03 | $630.96 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,949.84 | Facility | None | $239.88 | $616.60 | $1,949.84 |
United Setting Professional Modifier None Typical Low $257.04 Median $501.19 Typical High $912.01 | Professional | None | $257.04 | $501.19 | $912.01 |
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 $97.72 Median $125.89 Typical High $177.83 | Professional | 52 · Reduced service | $97.72 | $125.89 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $50.12 Typical High $70.79 | Professional | 53 · Discontinued | $38.90 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $190.55 Typical High $263.03 | Professional | 54 · Surgery only | $144.54 | $190.55 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $38.02 Typical High $52.48 | Professional | 55 · Aftercare only | $29.51 | $38.02 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $25.12 Typical High $35.48 | Professional | 56 · Pre-op care only | $19.50 | $25.12 | $35.48 |
Where Colorado sits
The same service costs 2.8 times more in Wisconsin than in Utah. 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· 5th of 51
$525
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.