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 $14.13 Median $33.11 Typical High $64.57 | Facility | None | $14.13 | $33.11 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.79 | Professional | None | $14.13 | $14.13 | $14.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.60 Median $25.12 Typical High $44.67 | Facility | None | $16.60 | $25.12 | $44.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.09 Median $3.63 Typical High $16.98 | Professional | None | $3.09 | $3.63 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Denver HMP Setting Facility Modifier None Typical Low $4.79 Median $14.13 Typical High $20.42 | Facility | None | $4.79 | $14.13 | $20.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $346.74 | Professional | None | $7.94 | $7.94 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $13.80 | Professional | None | $12.59 | $12.59 | $13.80 |
United Setting Professional Modifier None Typical Low $1.82 Median $2.19 Typical High $3.63 | Professional | None | $1.82 | $2.19 | $3.63 |
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 $7.08 Median $7.08 Typical High $7.41 | Professional | 52 · Reduced service | $7.08 | $7.08 | $7.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $2.95 | Professional | 53 · Discontinued | $2.82 | $2.82 | $2.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.14 Typical High $2.24 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.48 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.48 |
Where Colorado sits
The same service costs 4.8 times more in Maryland than in Kentucky. 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· 17th of 51
$14.79
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.