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 $112.20 Median $147.91 Typical High $190.55 | Facility | None | $112.20 | $147.91 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $158.49 | Professional | None | $112.20 | $144.54 | $158.49 |
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 $128.82 Median $181.97 Typical High $269.15 | Professional | None | $128.82 | $181.97 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $93.33 Typical High $165.96 | Facility | None | $52.48 | $93.33 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $239.88 | Professional | None | $128.82 | $165.96 | $239.88 |
Denver HMP Setting Facility Modifier None Typical Low $112.20 Median $158.49 Typical High $234.42 | Facility | None | $112.20 | $158.49 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $251.19 | Professional | None | $120.23 | $177.83 | $251.19 |
Select Health Setting Facility Modifier None Typical Low $109.65 Median $147.91 Typical High $316.23 | Facility | None | $109.65 | $147.91 | $316.23 |
Select Health Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $151.36 | Professional | None | $109.65 | $131.83 | $151.36 |
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 $123.03 Median $169.82 Typical High $281.84 | Professional | None | $123.03 | $169.82 | $281.84 |
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 $54.95 Median $70.79 Typical High $74.13 | Professional | 52 · Reduced service | $54.95 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $28.84 Typical High $29.51 | Professional | 53 · Discontinued | $22.39 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $21.38 Typical High $21.88 | Professional | 55 · Aftercare only | $16.60 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.45 Typical High $14.79 | Professional | 56 · Pre-op care only | $11.22 | $14.45 | $14.79 |
Where Colorado sits
The same service costs 4.3 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· 22nd of 51
$174
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.