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 $42.66 Median $42.66 Typical High $72.44 | Facility | None | $42.66 | $42.66 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $66.07 Typical High $77.62 | Professional | None | $42.66 | $66.07 | $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 $60.26 Median $97.72 Typical High $169.82 | Professional | None | $60.26 | $97.72 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $61.66 Typical High $95.50 | Facility | None | $47.86 | $61.66 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $79.43 Typical High $128.82 | Professional | None | $57.54 | $79.43 | $128.82 |
Denver HMP Setting Facility Modifier None Typical Low $42.66 Median $72.44 Typical High $102.33 | Facility | None | $42.66 | $72.44 | $102.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $77.62 Typical High $131.83 | Professional | None | $44.67 | $77.62 | $131.83 |
Select Health Setting Facility Modifier None Typical Low $58.88 Median $74.13 Typical High $154.88 | Facility | None | $58.88 | $74.13 | $154.88 |
Select Health Setting Professional Modifier None Typical Low $28.84 Median $74.13 Typical High $144.54 | Professional | None | $28.84 | $74.13 | $144.54 |
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 $57.54 Median $87.10 Typical High $147.91 | Professional | None | $57.54 | $87.10 | $147.91 |
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 $21.38 Median $33.88 Typical High $36.31 | Professional | 52 · Reduced service | $21.38 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $13.49 Typical High $14.45 | Professional | 53 · Discontinued | $8.71 | $13.49 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $10.00 Typical High $10.72 | Professional | 55 · Aftercare only | $6.46 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $6.76 Typical High $7.24 | Professional | 56 · Pre-op care only | $4.27 | $6.76 | $7.24 |
Where Colorado sits
The same service costs 3.1 times more in Wisconsin 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· 11th of 51
$100
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.