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 $17.78 Median $17.78 Typical High $27.54 | Facility | None | $17.78 | $17.78 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $17.78 Typical High $17.78 | Professional | None | $13.80 | $17.78 | $17.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $22.39 Typical High $32.36 | Professional | None | $16.60 | $22.39 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Denver HMP Setting Facility Modifier None Typical Low $15.85 Median $22.91 Typical High $28.18 | Facility | None | $15.85 | $22.91 | $28.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.60 Median $21.88 Typical High $33.88 | Professional | None | $16.60 | $21.88 | $33.88 |
Select Health Setting Facility Modifier None Typical Low $16.60 Median $30.90 Typical High $34.67 | Facility | None | $16.60 | $30.90 | $34.67 |
Select Health Setting Professional Modifier None Typical Low $13.18 Median $16.60 Typical High $26.30 | Professional | None | $13.18 | $16.60 | $26.30 |
United Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
United Setting Professional Modifier None Typical Low $14.79 Median $18.62 Typical High $27.54 | Professional | None | $14.79 | $18.62 | $27.54 |
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 $6.92 Median $8.91 Typical High $8.91 | Professional | 52 · Reduced service | $6.92 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $3.55 Typical High $3.55 | Professional | 53 · Discontinued | $2.75 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.63 Typical High $2.63 | Professional | 55 · Aftercare only | $2.09 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.78 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.38 | $1.78 | $1.78 |
Where Colorado sits
The same service costs 2.8 times more in Alaska than in Louisiana. 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· 18th of 51
$19.05
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.