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 $26.30 Median $43.65 Typical High $67.61 | Facility | None | $26.30 | $43.65 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $38.90 Typical High $53.70 | Professional | None | $23.44 | $38.90 | $53.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $61.66 Typical High $100.00 | Professional | None | $39.81 | $61.66 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $151.36 Typical High $190.55 | Facility | None | $128.82 | $151.36 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $44.67 Typical High $75.86 | Professional | None | $28.84 | $44.67 | $75.86 |
Denver HMP Setting Facility Modifier None Typical Low $31.62 Median $50.12 Typical High $83.18 | Facility | None | $31.62 | $50.12 | $83.18 |
Denver HMP Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $63.10 Typical High $102.33 | Professional | None | $37.15 | $63.10 | $102.33 |
Select Health Setting Facility Modifier None Typical Low $61.66 Median $63.10 Typical High $128.82 | Facility | None | $61.66 | $63.10 | $128.82 |
Select Health Setting Professional Modifier None Typical Low $29.51 Median $40.74 Typical High $61.66 | Professional | None | $29.51 | $40.74 | $61.66 |
United Setting Professional Modifier None Typical Low $27.54 Median $45.71 Typical High $69.18 | Professional | None | $27.54 | $45.71 | $69.18 |
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 $15.14 Median $18.20 Typical High $25.70 | Professional | 52 · Reduced service | $15.14 | $18.20 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.50 Typical High $7.76 | Professional | 55 · Aftercare only | $4.57 | $5.50 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.63 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.02 | $3.63 | $5.13 |
Kaiser Permanente Setting Professional Modifier HO · Master's level Typical Low $23.44 Median $33.11 Typical High $58.88 | Professional | HO · Master's level | $23.44 | $33.11 | $58.88 |
Where Colorado sits
The same service costs 2.4 times more in Alaska than in New Jersey. 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· 20th of 51
$45.71
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.