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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $77.62 | Professional | None | $69.18 | $69.18 | $77.62 |
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 $83.18 Median $117.49 Typical High $173.78 | Professional | None | $83.18 | $117.49 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $1,148.15 Typical High $1,659.59 | Facility | None | $416.87 | $1,148.15 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $141.25 | Professional | None | $83.18 | $107.15 | $141.25 |
Denver HMP Setting Facility Modifier None Typical Low $69.18 Median $95.50 Typical High $125.89 | Facility | None | $69.18 | $95.50 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $128.82 | Professional | None | $61.66 | $87.10 | $128.82 |
Select Health Setting Facility Modifier None Typical Low $61.66 Median $123.03 Typical High $407.38 | Facility | None | $61.66 | $123.03 | $407.38 |
Select Health Setting Professional Modifier None Typical Low $42.66 Median $61.66 Typical High $120.23 | Professional | None | $42.66 | $61.66 | $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 $83.18 Median $107.15 Typical High $165.96 | Professional | None | $83.18 | $107.15 | $165.96 |
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 $34.67 Median $34.67 Typical High $38.90 | Professional | 52 · Reduced service | $34.67 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $15.49 | Professional | 53 · Discontinued | $13.80 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $11.75 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $7.76 |
Where Colorado sits
The same service costs 4.5 times more in Wisconsin 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· 9th of 51
$141
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.