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 $114.82 Median $199.53 Typical High $524.81 | Facility | None | $114.82 | $199.53 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $169.82 | Professional | None | $64.57 | $87.10 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $346.74 Typical High $524.81 | Facility | None | $120.23 | $346.74 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $79.43 Typical High $234.42 | Professional | None | $47.86 | $79.43 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $138.04 Typical High $363.08 | Facility | None | $67.61 | $138.04 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $147.91 | Professional | None | $60.26 | $60.26 | $147.91 |
Denver HMP Setting Facility Modifier None Typical Low $87.10 Median $102.33 Typical High $138.04 | Facility | None | $87.10 | $102.33 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $295.12 | Professional | None | $91.20 | $162.18 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $213.80 Typical High $239.88 | Facility | None | $114.82 | $213.80 | $239.88 |
Select Health Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $114.82 | Professional | None | $79.43 | $79.43 | $114.82 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $33.88 Median $47.86 Typical High $85.11 | Professional | None | $33.88 | $47.86 | $85.11 |
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 $39.81 Median $43.65 Typical High $57.54 | Professional | 52 · Reduced service | $39.81 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $17.38 Typical High $22.91 | Professional | 53 · Discontinued | $15.85 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $64.57 Typical High $85.11 | Professional | 54 · Surgery only | $60.26 | $64.57 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $13.18 Typical High $16.98 | Professional | 55 · Aftercare only | $12.02 | $13.18 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.71 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.94 | $8.71 | $11.48 |
Where Colorado sits
The same service costs 4.9 times more in Alaska than in Georgia. 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· 12th of 51
$115
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.