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 $72.44 Median $3,162.28 Typical High $8,912.51 | Facility | None | $72.44 | $3,162.28 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $151.36 Typical High $223.87 | Professional | None | $69.18 | $151.36 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $213.80 Typical High $416.87 | Professional | None | $87.10 | $213.80 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $177.83 Typical High $363.08 | Professional | None | $75.86 | $177.83 | $363.08 |
Denver HMP Setting Facility Modifier None Typical Low $72.44 Median $186.21 Typical High $288.40 | Facility | None | $72.44 | $186.21 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $158.49 Typical High $398.11 | Professional | None | $69.18 | $158.49 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $109.65 Median $208.93 Typical High $436.52 | Facility | None | $109.65 | $208.93 | $436.52 |
Select Health Setting Professional Modifier None Typical Low $52.48 Median $93.33 Typical High $208.93 | Professional | None | $52.48 | $93.33 | $208.93 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $70.79 Median $173.78 Typical High $363.08 | Professional | None | $70.79 | $173.78 | $363.08 |
5 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 $34.67 Median $72.44 Typical High $112.20 | Professional | 52 · Reduced service | $34.67 | $72.44 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $28.84 Typical High $44.67 | Professional | 53 · Discontinued | $13.80 | $28.84 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $107.15 Typical High $165.96 | Professional | 54 · Surgery only | $52.48 | $107.15 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $21.38 Typical High $33.88 | Professional | 55 · Aftercare only | $10.47 | $21.38 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $14.45 Typical High $22.39 | Professional | 56 · Pre-op care only | $6.92 | $14.45 | $22.39 |
Where Colorado sits
The same service costs 2.9 times more in Washington than in Kentucky. 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· 21st of 51
$182
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.