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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $52.48 | Professional | None | $45.71 | $45.71 | $52.48 |
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 $53.70 Median $75.86 Typical High $112.20 | Professional | None | $53.70 | $75.86 | $112.20 |
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 $57.54 Median $70.79 Typical High $93.33 | Professional | None | $57.54 | $70.79 | $93.33 |
Denver HMP Setting Facility Modifier None Typical Low $45.71 Median $64.57 Typical High $95.50 | Facility | None | $45.71 | $64.57 | $95.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $40.74 Median $57.54 Typical High $85.11 | Professional | None | $40.74 | $57.54 | $85.11 |
Select Health Setting Facility Modifier None Typical Low $40.74 Median $81.28 Typical High $407.38 | Facility | None | $40.74 | $81.28 | $407.38 |
Select Health Setting Professional Modifier None Typical Low $28.18 Median $40.74 Typical High $79.43 | Professional | None | $28.18 | $40.74 | $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 $54.95 Median $72.44 Typical High $109.65 | Professional | None | $54.95 | $72.44 | $109.65 |
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 $22.91 Median $22.91 Typical High $25.70 | Professional | 52 · Reduced service | $22.91 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $10.47 | Professional | 53 · Discontinued | $9.12 | $9.12 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $7.76 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $5.25 |
Where Colorado sits
The same service costs 4.7 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· 10th of 51
$93.33
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.