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 $64.57 Median $93.33 Typical High $144.54 | Facility | None | $64.57 | $93.33 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $125.89 | Professional | None | $64.57 | $91.20 | $125.89 |
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 $102.33 Typical High $154.88 | Professional | None | $72.44 | $102.33 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $91.20 Typical High $158.49 | Facility | None | $52.48 | $91.20 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $144.54 | Professional | None | $63.10 | $93.33 | $144.54 |
Denver HMP Setting Facility Modifier None Typical Low $64.57 Median $93.33 Typical High $147.91 | Facility | None | $64.57 | $93.33 | $147.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $165.96 | Professional | None | $72.44 | $112.20 | $165.96 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $112.20 Typical High $213.80 | Facility | None | $100.00 | $112.20 | $213.80 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $100.00 | Professional | None | $63.10 | $77.62 | $100.00 |
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 $67.61 Median $95.50 Typical High $165.96 | Professional | None | $67.61 | $95.50 | $165.96 |
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 $32.36 Median $39.81 Typical High $45.71 | Professional | 52 · Reduced service | $32.36 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.22 Typical High $18.62 | Professional | 53 · Discontinued | $12.88 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.02 Typical High $13.80 | Professional | 55 · Aftercare only | $9.55 | $12.02 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.94 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.46 | $7.94 | $9.33 |
Where Colorado sits
The same service costs 3.7 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· 23rd of 51
$100
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.