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 $22.91 Median $22.91 Typical High $25.70 | Facility | None | $22.91 | $22.91 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $22.91 Typical High $25.70 | Professional | None | $18.62 | $22.91 | $25.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $22.91 Typical High $33.88 | Professional | None | $17.38 | $22.91 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Denver HMP Setting Facility Modifier None Typical Low $17.78 Median $25.12 Typical High $40.74 | Facility | None | $17.78 | $25.12 | $40.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.14 Median $20.89 Typical High $30.90 | Professional | None | $15.14 | $20.89 | $30.90 |
Select Health Setting Facility Modifier None Typical Low $17.78 Median $25.12 Typical High $37.15 | Facility | None | $17.78 | $25.12 | $37.15 |
Select Health Setting Professional Modifier None Typical Low $12.88 Median $16.60 Typical High $21.38 | Professional | None | $12.88 | $16.60 | $21.38 |
United Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
United Setting Professional Modifier None Typical Low $15.14 Median $19.05 Typical High $28.84 | Professional | None | $15.14 | $19.05 | $28.84 |
5 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 $9.33 Median $11.48 Typical High $12.88 | Professional | 52 · Reduced service | $9.33 | $11.48 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $4.68 Typical High $5.13 | Professional | 53 · Discontinued | $3.80 | $4.68 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.47 Typical High $3.89 | Professional | 55 · Aftercare only | $2.82 | $3.47 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $2.29 Typical High $2.57 | Professional | 56 · Pre-op care only | $1.91 | $2.29 | $2.57 |
Kaiser Permanente Setting Professional Modifier HO · Master's level Typical Low $9.55 Median $13.18 Typical High $16.60 | Professional | HO · Master's level | $9.55 | $13.18 | $16.60 |
Where Colorado sits
The same service costs 3.2 times more in Alaska than in New York. 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· 11th of 51
$22.39
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.