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 $54.95 Median $85.11 Typical High $245.47 | Facility | None | $54.95 | $85.11 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $95.50 Typical High $158.49 | Professional | None | $46.77 | $95.50 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $141.25 Typical High $263.03 | Professional | None | $54.95 | $141.25 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $123.03 Typical High $199.53 | Professional | None | $50.12 | $123.03 | $199.53 |
Denver HMP Setting Facility Modifier None Typical Low $54.95 Median $141.25 Typical High $213.80 | Facility | None | $54.95 | $141.25 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $114.82 Typical High $239.88 | Professional | None | $46.77 | $114.82 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $75.86 Median $138.04 Typical High $288.40 | Facility | None | $75.86 | $138.04 | $288.40 |
Select Health Setting Professional Modifier None Typical Low $37.15 Median $47.86 Typical High $138.04 | Professional | None | $37.15 | $47.86 | $138.04 |
United Setting Facility Modifier None Typical Low $933.25 Median $977.24 Typical High $1,122.02 | Facility | None | $933.25 | $977.24 | $1,122.02 |
United Setting Professional Modifier None Typical Low $50.12 Median $112.20 Typical High $208.93 | Professional | None | $50.12 | $112.20 | $208.93 |
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 $23.44 Median $41.69 Typical High $79.43 | Professional | 52 · Reduced service | $23.44 | $41.69 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $16.60 Typical High $31.62 | Professional | 53 · Discontinued | $9.55 | $16.60 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $12.59 Typical High $23.99 | Professional | 55 · Aftercare only | $7.08 | $12.59 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $8.32 Typical High $15.85 | Professional | 56 · Pre-op care only | $4.79 | $8.32 | $15.85 |
Where Colorado sits
The same service costs 3.5 times more in Wisconsin 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· 21st of 51
$123
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.