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 $34.67 Median $34.67 Typical High $56.23 | Facility | None | $34.67 | $34.67 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $48.98 Typical High $56.23 | Professional | None | $34.67 | $48.98 | $56.23 |
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 $39.81 Median $56.23 Typical High $83.18 | Professional | None | $39.81 | $56.23 | $83.18 |
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 $35.48 Median $53.70 Typical High $87.10 | Professional | None | $35.48 | $53.70 | $87.10 |
Denver HMP Setting Facility Modifier None Typical Low $34.67 Median $56.23 Typical High $81.28 | Facility | None | $34.67 | $56.23 | $81.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.02 Median $63.10 Typical High $102.33 | Professional | None | $38.02 | $63.10 | $102.33 |
Select Health Setting Facility Modifier None Typical Low $61.66 Median $63.10 Typical High $128.82 | Facility | None | $61.66 | $63.10 | $128.82 |
Select Health Setting Professional Modifier None Typical Low $34.67 Median $40.74 Typical High $61.66 | Professional | None | $34.67 | $40.74 | $61.66 |
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 $35.48 Median $56.23 Typical High $97.72 | Professional | None | $35.48 | $56.23 | $97.72 |
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 $17.38 Median $23.99 Typical High $28.18 | Professional | 52 · Reduced service | $17.38 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $9.55 Typical High $11.22 | Professional | 53 · Discontinued | $6.92 | $9.55 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $7.08 Typical High $8.51 | Professional | 55 · Aftercare only | $5.25 | $7.08 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $4.79 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.47 | $4.79 | $5.62 |
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· 24th of 51
$57.54
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.