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 $40.74 Median $85.11 Typical High $128.82 | Facility | None | $40.74 | $85.11 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $79.43 Typical High $117.49 | Professional | None | $40.74 | $79.43 | $117.49 |
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 $48.98 Median $67.61 Typical High $100.00 | Professional | None | $48.98 | $67.61 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $89.13 Typical High $151.36 | Facility | None | $52.48 | $89.13 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $87.10 Typical High $134.90 | Professional | None | $54.95 | $87.10 | $134.90 |
Denver HMP Setting Facility Modifier None Typical Low $40.74 Median $85.11 Typical High $123.03 | Facility | None | $40.74 | $85.11 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $83.18 Typical High $162.18 | Professional | None | $44.67 | $83.18 | $162.18 |
Select Health Setting Facility Modifier None Typical Low $74.13 Median $102.33 Typical High $208.93 | Facility | None | $74.13 | $102.33 | $208.93 |
Select Health Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $100.00 | Professional | None | $39.81 | $47.86 | $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 $52.48 Median $87.10 Typical High $151.36 | Professional | None | $52.48 | $87.10 | $151.36 |
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 $20.42 Median $33.11 Typical High $42.66 | Professional | 52 · Reduced service | $20.42 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $13.18 Typical High $17.38 | Professional | 53 · Discontinued | $8.13 | $13.18 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $9.77 Typical High $12.88 | Professional | 55 · Aftercare only | $6.17 | $9.77 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.61 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.07 | $6.61 | $8.71 |
Where Colorado sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 28th of 51
$85.11
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.