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 $83.18 Median $131.83 Typical High $346.74 | Facility | None | $83.18 | $131.83 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $162.18 | Professional | None | $83.18 | $83.18 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $144.54 Typical High $239.88 | Facility | None | $89.13 | $144.54 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $95.50 Typical High $117.49 | Facility | None | $85.11 | $95.50 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Denver HMP Setting Facility Modifier None Typical Low $83.18 Median $93.33 Typical High $120.23 | Facility | None | $83.18 | $93.33 | $120.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $165.96 | Professional | None | $63.10 | $93.33 | $165.96 |
Select Health Setting Facility Modifier None Typical Low $83.18 Median $154.88 Typical High $177.83 | Facility | None | $83.18 | $154.88 | $177.83 |
Select Health Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $83.18 | Professional | None | $58.88 | $58.88 | $83.18 |
United Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
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 $41.69 Median $41.69 Typical High $81.28 | Professional | 52 · Reduced service | $41.69 | $41.69 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $32.36 | Professional | 53 · Discontinued | $16.98 | $16.98 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $24.55 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $16.22 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $16.22 |
Where Colorado sits
The same service costs 1.5 times more in Arizona than in Nebraska. 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· 4th of 51
$100
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.