How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $630.96 Typical High $630.96 | Professional | None | $5.75 | $630.96 | $630.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $147.91 | Professional | None | $83.18 | $107.15 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Denver HMP Setting Facility Modifier None Typical Low $562.34 Median $630.96 Typical High $912.01 | Facility | None | $562.34 | $630.96 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $346.74 | Professional | None | $154.88 | $154.88 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $3,162.28 Typical High $3,630.78 | Facility | None | $3,019.95 | $3,162.28 | $3,630.78 |
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 $2.88 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $2.88 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.15 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $1.15 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $0.87 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.58 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $0.58 | $63.10 | $63.10 |
Where Colorado sits
The same service costs 190.5 times more in North Carolina 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· 29th of 51
$120
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.