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 $42.66 Median $85.11 Typical High $181.97 | Facility | None | $42.66 | $85.11 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $83.18 | Professional | None | $42.66 | $42.66 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $131.83 | Facility | None | $50.12 | $75.86 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $45.71 | Professional | None | $44.67 | $44.67 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Denver HMP Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $61.66 | Facility | None | $42.66 | $42.66 | $61.66 |
Select Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
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 $21.38 Median $21.38 Typical High $41.69 | Professional | 52 · Reduced service | $21.38 | $21.38 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $16.60 | Professional | 53 · Discontinued | $8.51 | $8.51 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $12.59 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $8.32 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $8.32 |
Where Colorado sits
The same service costs 17.8 times more in Alabama than in North Dakota. 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· 5th of 51
$66.07
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.