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 $69.18 Median $102.33 Typical High $158.49 | Facility | None | $69.18 | $102.33 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $102.33 Typical High $141.25 | Professional | None | $69.18 | $102.33 | $141.25 |
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 $77.62 Median $112.20 Typical High $165.96 | Professional | None | $77.62 | $112.20 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $95.50 Typical High $173.78 | Facility | None | $52.48 | $95.50 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $158.49 | Professional | None | $70.79 | $102.33 | $158.49 |
Denver HMP Setting Facility Modifier None Typical Low $69.18 Median $102.33 Typical High $162.18 | Facility | None | $69.18 | $102.33 | $162.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $186.21 | Professional | None | $79.43 | $123.03 | $186.21 |
Select Health Setting Facility Modifier None Typical Low $112.20 Median $123.03 Typical High $234.42 | Facility | None | $112.20 | $123.03 | $234.42 |
Select Health Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $112.20 | Professional | None | $69.18 | $85.11 | $112.20 |
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 $74.13 Median $104.71 Typical High $181.97 | Professional | None | $74.13 | $104.71 | $181.97 |
4 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 $34.67 Median $43.65 Typical High $51.29 | Professional | 52 · Reduced service | $34.67 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $17.78 Typical High $20.42 | Professional | 53 · Discontinued | $13.80 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $13.18 Typical High $15.14 | Professional | 55 · Aftercare only | $10.47 | $13.18 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.71 Typical High $10.23 | Professional | 56 · Pre-op care only | $6.92 | $8.71 | $10.23 |
Where Colorado sits
The same service costs 3.6 times more in Alaska 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· 21st 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.