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 $75.86 Median $75.86 Typical High $109.65 | Facility | None | $75.86 | $75.86 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $109.65 | Professional | None | $75.86 | $97.72 | $109.65 |
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 $87.10 Median $123.03 Typical High $186.21 | Professional | None | $87.10 | $123.03 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $91.20 Typical High $158.49 | Facility | None | $52.48 | $91.20 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $173.78 | Professional | None | $83.18 | $112.20 | $173.78 |
Denver HMP Setting Facility Modifier None Typical Low $75.86 Median $109.65 Typical High $169.82 | Facility | None | $75.86 | $109.65 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $131.83 Typical High $199.53 | Professional | None | $81.28 | $131.83 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $107.15 Median $120.23 Typical High $251.19 | Facility | None | $107.15 | $120.23 | $251.19 |
Select Health Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $120.23 | Professional | None | $75.86 | $87.10 | $120.23 |
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 $85.11 Median $114.82 Typical High $199.53 | Professional | None | $85.11 | $114.82 | $199.53 |
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 $38.02 Median $48.98 Typical High $54.95 | Professional | 52 · Reduced service | $38.02 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $19.50 Typical High $21.88 | Professional | 53 · Discontinued | $15.14 | $19.50 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.79 Typical High $16.60 | Professional | 55 · Aftercare only | $11.48 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.77 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.59 | $9.77 | $10.96 |
Where Colorado sits
The same service costs 3.8 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· 21st of 51
$123
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.