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 $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $19.05 Typical High $19.05 | Professional | None | $16.98 | $19.05 | $19.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $26.92 Typical High $37.15 | Professional | None | $20.42 | $26.92 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $23.44 Typical High $31.62 | Professional | None | $19.95 | $23.44 | $31.62 |
Denver HMP Setting Facility Modifier None Typical Low $19.05 Median $23.99 Typical High $26.92 | Facility | None | $19.05 | $23.99 | $26.92 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.38 Median $26.30 Typical High $41.69 | Professional | None | $21.38 | $26.30 | $41.69 |
Select Health Setting Facility Modifier None Typical Low $15.14 Median $18.62 Typical High $39.81 | Facility | None | $15.14 | $18.62 | $39.81 |
Select Health Setting Professional Modifier None Typical Low $14.45 Median $18.62 Typical High $29.51 | Professional | None | $14.45 | $18.62 | $29.51 |
United Setting Professional Modifier None Typical Low $18.20 Median $23.44 Typical High $35.48 | Professional | None | $18.20 | $23.44 | $35.48 |
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 $8.51 Median $9.55 Typical High $9.55 | Professional | 52 · Reduced service | $8.51 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.80 Typical High $3.80 | Professional | 53 · Discontinued | $3.39 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.82 Typical High $2.88 | Professional | 55 · Aftercare only | $2.51 | $2.82 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.91 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.70 | $1.91 | $1.91 |
Where Colorado sits
The same service costs 3.4 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· 18th of 51
$23.99
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.