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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $245.47 Typical High $331.13 | Professional | None | $213.80 | $245.47 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $588.84 | Professional | None | $251.19 | $338.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $354.81 | Professional | None | $218.78 | $251.19 | $354.81 |
Denver HMP Setting Facility Modifier None Typical Low $223.87 Median $245.47 Typical High $354.81 | Facility | None | $223.87 | $245.47 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $457.09 | Professional | None | $229.09 | $316.23 | $457.09 |
Select Health Setting Facility Modifier None Typical Low $229.09 Median $426.58 Typical High $478.63 | Facility | None | $229.09 | $426.58 | $478.63 |
Select Health Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $323.59 | Professional | None | $162.18 | $229.09 | $323.59 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $389.05 | Professional | None | $218.78 | $263.03 | $389.05 |
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 $112.20 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $112.20 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $44.67 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $33.88 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $22.39 | $24.55 | $24.55 |
Where Colorado sits
The same service costs 3.0 times more in Wisconsin 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· 15th of 51
$302
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.