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 $380.19 Typical High $1,047.13 | Facility | None | $245.47 | $380.19 | $1,047.13 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $257.04 | Professional | None | $245.47 | $245.47 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $426.58 Typical High $724.44 | Facility | None | $269.15 | $426.58 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Denver HMP Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $354.81 | Facility | None | $245.47 | $245.47 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $537.03 | Professional | None | $316.23 | $363.08 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $436.52 | Facility | None | $398.11 | $398.11 | $436.52 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $436.52 | Professional | None | $281.84 | $389.05 | $436.52 |
United Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
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 $123.03 Median $123.03 Typical High $128.82 | Professional | 52 · Reduced service | $123.03 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $51.29 | Professional | 53 · Discontinued | $48.98 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $38.02 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $25.70 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $25.70 |
Where Colorado sits
The same service costs 1.7 times more in Alaska than in Indiana. 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· 40th of 51
$257
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.