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 $43.65 Median $43.65 Typical High $91.20 | Facility | None | $43.65 | $43.65 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $67.61 Typical High $91.20 | Professional | None | $43.65 | $67.61 | $91.20 |
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 $50.12 Median $70.79 Typical High $104.71 | Professional | None | $50.12 | $70.79 | $104.71 |
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 $46.77 Median $81.28 Typical High $138.04 | Professional | None | $46.77 | $81.28 | $138.04 |
Denver HMP Setting Facility Modifier None Typical Low $43.65 Median $89.13 Typical High $128.82 | Facility | None | $43.65 | $89.13 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $87.10 Typical High $169.82 | Professional | None | $46.77 | $87.10 | $169.82 |
Select Health Setting Facility Modifier None Typical Low $77.62 Median $112.20 Typical High $213.80 | Facility | None | $77.62 | $112.20 | $213.80 |
Select Health Setting Professional Modifier None Typical Low $43.65 Median $50.12 Typical High $102.33 | Professional | None | $43.65 | $50.12 | $102.33 |
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 $47.86 Median $85.11 Typical High $151.36 | Professional | None | $47.86 | $85.11 | $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 $21.88 Median $33.88 Typical High $45.71 | Professional | 52 · Reduced service | $21.88 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $13.49 Typical High $18.20 | Professional | 53 · Discontinued | $8.71 | $13.49 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $10.23 Typical High $13.80 | Professional | 55 · Aftercare only | $6.61 | $10.23 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.76 Typical High $9.12 | Professional | 56 · Pre-op care only | $4.37 | $6.76 | $9.12 |
Where Colorado sits
The same service costs 3.9 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· 19th 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.