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 $15.49 Median $24.55 Typical High $125.89 | Facility | None | $15.49 | $24.55 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $61.66 Typical High $79.43 | Professional | None | $15.49 | $61.66 | $79.43 |
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 $18.62 Median $26.30 Typical High $38.90 | Professional | None | $18.62 | $26.30 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $87.10 Typical High $724.44 | Facility | None | $58.88 | $87.10 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $74.13 Typical High $128.82 | Professional | None | $18.62 | $74.13 | $128.82 |
Denver HMP Setting Facility Modifier None Typical Low $15.49 Median $33.88 Typical High $114.82 | Facility | None | $15.49 | $33.88 | $114.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.22 Median $52.48 Typical High $134.90 | Professional | None | $16.22 | $52.48 | $134.90 |
Select Health Setting Facility Modifier None Typical Low $26.92 Median $97.72 Typical High $165.96 | Facility | None | $26.92 | $97.72 | $165.96 |
Select Health Setting Professional Modifier None Typical Low $15.49 Median $17.78 Typical High $79.43 | Professional | None | $15.49 | $17.78 | $79.43 |
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 $18.20 Median $64.57 Typical High $138.04 | Professional | None | $18.20 | $64.57 | $138.04 |
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 $7.76 Median $28.84 Typical High $39.81 | Professional | 52 · Reduced service | $7.76 | $28.84 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $11.48 Typical High $15.85 | Professional | 53 · Discontinued | $3.09 | $11.48 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $8.71 Typical High $12.02 | Professional | 55 · Aftercare only | $2.34 | $8.71 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $5.75 Typical High $7.94 | Professional | 56 · Pre-op care only | $1.55 | $5.75 | $7.94 |
Where Colorado sits
The same service costs 5.9 times more in Iowa 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· 43rd of 51
$35.48
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.