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 $66.07 | Facility | None | $43.65 | $43.65 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $66.07 | Professional | None | $43.65 | $60.26 | $66.07 |
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 $51.29 Median $70.79 Typical High $107.15 | Professional | None | $51.29 | $70.79 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $63.10 Typical High $95.50 | Facility | None | $48.98 | $63.10 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $67.61 Typical High $104.71 | Professional | None | $48.98 | $67.61 | $104.71 |
Denver HMP Setting Facility Modifier None Typical Low $43.65 Median $66.07 Typical High $97.72 | Facility | None | $43.65 | $66.07 | $97.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $75.86 Typical High $117.49 | Professional | None | $46.77 | $75.86 | $117.49 |
Select Health Setting Facility Modifier None Typical Low $60.26 Median $69.18 Typical High $144.54 | Facility | None | $60.26 | $69.18 | $144.54 |
Select Health Setting Professional Modifier None Typical Low $43.65 Median $50.12 Typical High $69.18 | Professional | None | $43.65 | $50.12 | $69.18 |
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 $70.79 Typical High $120.23 | Professional | None | $47.86 | $70.79 | $120.23 |
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 $28.84 Typical High $33.11 | Professional | 52 · Reduced service | $21.88 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $11.75 Typical High $13.18 | Professional | 53 · Discontinued | $8.71 | $11.75 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $8.71 Typical High $10.00 | Professional | 55 · Aftercare only | $6.61 | $8.71 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.75 Typical High $6.61 | Professional | 56 · Pre-op care only | $4.37 | $5.75 | $6.61 |
Where Colorado sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 23rd of 51
$72.44
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.