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 $89.13 Median $134.90 Typical High $194.98 | Facility | None | $89.13 | $134.90 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $165.96 | Professional | None | $89.13 | $97.72 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $245.47 | Professional | None | $117.49 | $165.96 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,819.70 Typical High $3,311.31 | Facility | None | $478.63 | $1,819.70 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $208.93 | Professional | None | $109.65 | $147.91 | $208.93 |
Denver HMP Setting Facility Modifier None Typical Low $89.13 Median $125.89 Typical High $158.49 | Facility | None | $89.13 | $125.89 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $194.98 | Professional | None | $91.20 | $128.82 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $186.21 Typical High $2,884.03 | Facility | None | $91.20 | $186.21 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $177.83 | Professional | None | $64.57 | $91.20 | $177.83 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,762.47 | Facility | None | $1,288.25 | $2,511.89 | $7,762.47 |
United Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $234.42 | Professional | None | $120.23 | $151.36 | $234.42 |
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 $44.67 Median $44.67 Typical High $56.23 | Professional | 52 · Reduced service | $44.67 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $22.39 | Professional | 53 · Discontinued | $17.78 | $17.78 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $16.60 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $11.22 |
Where Colorado sits
The same service costs 7.9 times more in Kansas than in New York. 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· 16th of 51
$195
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.