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 $87.10 Median $87.10 Typical High $128.82 | Facility | None | $87.10 | $87.10 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $131.83 | Professional | None | $87.10 | $120.23 | $131.83 |
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 $100.00 Median $141.25 Typical High $213.80 | Professional | None | $100.00 | $141.25 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $117.49 Typical High $213.80 | Facility | None | $52.48 | $117.49 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $204.17 | Professional | None | $91.20 | $131.83 | $204.17 |
Denver HMP Setting Facility Modifier None Typical Low $87.10 Median $128.82 Typical High $208.93 | Facility | None | $87.10 | $128.82 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $234.42 | Professional | None | $100.00 | $154.88 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $154.88 Typical High $302.00 | Facility | None | $144.54 | $154.88 | $302.00 |
Select Health Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $144.54 | Professional | None | $87.10 | $107.15 | $144.54 |
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 $95.50 Median $134.90 Typical High $234.42 | Professional | None | $95.50 | $134.90 | $234.42 |
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 $43.65 Median $56.23 Typical High $64.57 | Professional | 52 · Reduced service | $43.65 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $22.39 Typical High $25.70 | Professional | 53 · Discontinued | $17.78 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $16.98 Typical High $19.50 | Professional | 55 · Aftercare only | $13.18 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.22 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.71 | $11.22 | $12.88 |
Where Colorado sits
The same service costs 3.6 times more in Alaska than in Maryland. 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
$141
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.