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 $302.00 Median $346.74 Typical High $457.09 | Facility | None | $302.00 | $346.74 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $457.09 | Professional | None | $302.00 | $354.81 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $758.58 | Professional | None | $338.84 | $478.63 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $851.14 | Professional | None | $426.58 | $602.56 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $1,047.13 | Facility | None | $501.19 | $724.44 | $1,047.13 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $630.96 | Professional | None | $338.84 | $478.63 | $630.96 |
United Setting Facility Modifier None Typical Low $776.25 Median $812.83 Typical High $933.25 | Facility | None | $776.25 | $812.83 | $933.25 |
United Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $660.69 | Professional | None | $331.13 | $457.09 | $660.69 |
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 $199.53 Median $208.93 Typical High $229.09 | Professional | 52 · Reduced service | $199.53 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $83.18 Typical High $93.33 | Professional | 53 · Discontinued | $79.43 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $63.10 Typical High $69.18 | Professional | 55 · Aftercare only | $60.26 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $41.69 Typical High $45.71 | Professional | 56 · Pre-op care only | $39.81 | $41.69 | $45.71 |
Kaiser Permanente Setting Professional Modifier HO · Master's level Typical Low $275.42 Median $380.19 Typical High $478.63 | Professional | HO · Master's level | $275.42 | $380.19 | $478.63 |
Where Colorado sits
The same service costs 2.1 times more in Wyoming than in Maryland. 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· 19th of 51
$427
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.