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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $151.36 | Professional | None | $70.79 | $104.71 | $151.36 |
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 $95.50 Median $173.78 Typical High $363.08 | Professional | None | $95.50 | $173.78 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $177.83 | Professional | None | $81.28 | $125.89 | $177.83 |
Denver HMP Setting Facility Modifier None Typical Low $72.44 Median $104.71 Typical High $190.55 | Facility | None | $72.44 | $104.71 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $275.42 | Professional | None | $79.43 | $141.25 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $123.03 Typical High $251.19 | Facility | None | $117.49 | $123.03 | $251.19 |
Select Health Setting Professional Modifier None Typical Low $58.88 Median $89.13 Typical High $173.78 | Professional | None | $58.88 | $89.13 | $173.78 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $4,677.35 Typical High $13,182.57 | Facility | None | $2,570.40 | $4,677.35 | $13,182.57 |
United Setting Professional Modifier None Typical Low $75.86 Median $131.83 Typical High $229.09 | Professional | None | $75.86 | $131.83 | $229.09 |
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 $35.48 Median $52.48 Typical High $67.61 | Professional | 52 · Reduced service | $35.48 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $20.89 Typical High $27.54 | Professional | 53 · Discontinued | $14.13 | $20.89 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $15.49 Typical High $20.42 | Professional | 55 · Aftercare only | $10.72 | $15.49 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $10.47 Typical High $13.49 | Professional | 56 · Pre-op care only | $7.08 | $10.47 | $13.49 |
Where Colorado sits
The same service costs 8.7 times more in Oklahoma than in Michigan. 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· 6th of 51
$251
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.