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 $19.05 Median $30.20 Typical High $134.90 | Facility | None | $19.05 | $30.20 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $48.98 Typical High $87.10 | Professional | None | $19.05 | $48.98 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $58.88 Typical High $114.82 | Professional | None | $19.95 | $58.88 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $64.57 Typical High $107.15 | Professional | None | $21.88 | $64.57 | $107.15 |
Denver HMP Setting Facility Modifier None Typical Low $19.05 Median $38.02 Typical High $134.90 | Facility | None | $19.05 | $38.02 | $134.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.50 Median $72.44 Typical High $151.36 | Professional | None | $19.50 | $72.44 | $151.36 |
Select Health Setting Facility Modifier None Typical Low $32.36 Median $91.20 Typical High $190.55 | Facility | None | $32.36 | $91.20 | $190.55 |
Select Health Setting Professional Modifier None Typical Low $14.79 Median $21.38 Typical High $91.20 | Professional | None | $14.79 | $21.38 | $91.20 |
United Setting Facility Modifier None Typical Low $257.04 Median $269.15 Typical High $309.03 | Facility | None | $257.04 | $269.15 | $309.03 |
United Setting Professional Modifier None Typical Low $21.38 Median $56.23 Typical High $102.33 | Professional | None | $21.38 | $56.23 | $102.33 |
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 $9.55 Median $24.55 Typical High $43.65 | Professional | 52 · Reduced service | $9.55 | $24.55 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $9.77 Typical High $17.38 | Professional | 53 · Discontinued | $3.80 | $9.77 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $7.41 Typical High $12.88 | Professional | 55 · Aftercare only | $2.88 | $7.41 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $3.80 Typical High $8.71 | Professional | 56 · Pre-op care only | $1.91 | $3.80 | $8.71 |
Kaiser Permanente Setting Professional Modifier HO · Master's level Typical Low $12.30 Median $17.38 Typical High $87.10 | Professional | HO · Master's level | $12.30 | $17.38 | $87.10 |
Where Colorado sits
The same service costs 4.9 times more in Hawaii than in Washington, DC. 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· 30th of 51
$56.23
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.