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 $35.48 Median $54.95 Typical High $162.18 | Facility | None | $35.48 | $54.95 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $67.61 Typical High $104.71 | Professional | None | $30.20 | $67.61 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $93.33 Typical High $169.82 | Professional | None | $36.31 | $93.33 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $81.28 Typical High $131.83 | Professional | None | $33.88 | $81.28 | $131.83 |
Denver HMP Setting Facility Modifier None Typical Low $34.67 Median $93.33 Typical High $147.91 | Facility | None | $34.67 | $93.33 | $147.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $29.51 Median $72.44 Typical High $154.88 | Professional | None | $29.51 | $72.44 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $47.86 Median $89.13 Typical High $186.21 | Facility | None | $47.86 | $89.13 | $186.21 |
Select Health Setting Professional Modifier None Typical Low $23.99 Median $30.90 Typical High $89.13 | Professional | None | $23.99 | $30.90 | $89.13 |
United Setting Facility Modifier None Typical Low $316.23 Median $331.13 Typical High $380.19 | Facility | None | $316.23 | $331.13 | $380.19 |
United Setting Professional Modifier None Typical Low $33.11 Median $74.13 Typical High $151.36 | Professional | None | $33.11 | $74.13 | $151.36 |
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 $15.49 Median $25.70 Typical High $51.29 | Professional | 52 · Reduced service | $15.49 | $25.70 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $10.23 Typical High $20.89 | Professional | 53 · Discontinued | $6.17 | $10.23 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $7.76 Typical High $15.49 | Professional | 55 · Aftercare only | $4.68 | $7.76 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $5.13 Typical High $10.23 | Professional | 56 · Pre-op care only | $3.09 | $5.13 | $10.23 |
Where Colorado sits
The same service costs 3.6 times more in North Carolina 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· 22nd of 51
$83.18
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.