How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $75.86 Median $75.86 Typical High $1,071.52 | Facility | None | $75.86 | $75.86 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $95.50 | Professional | None | $69.18 | $75.86 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $147.91 | Professional | None | $81.28 | $107.15 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $128.82 | Professional | None | $74.13 | $89.13 | $128.82 |
Denver HMP Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $112.20 | Facility | None | $75.86 | $87.10 | $112.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $138.04 | Professional | None | $70.79 | $87.10 | $138.04 |
Select Health Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $131.83 | Facility | None | $50.12 | $61.66 | $131.83 |
Select Health Setting Professional Modifier None Typical Low $58.88 Median $69.18 Typical High $109.65 | Professional | None | $58.88 | $69.18 | $109.65 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $3,162.28 Typical High $3,630.78 | Facility | None | $3,019.95 | $3,162.28 | $3,630.78 |
United Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $141.25 | Professional | None | $72.44 | $91.20 | $141.25 |
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 $33.88 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $33.88 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $13.49 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $10.00 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.76 | $7.59 | $7.59 |
Where Colorado sits
The same service costs 3.2 times more in Alaska 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· 15th of 51
$95.50
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.