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 $338.84 Median $660.69 Typical High $1,380.38 | Facility | None | $338.84 | $660.69 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $660.69 | Professional | None | $338.84 | $338.84 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $354.81 Median $575.44 Typical High $954.99 | Facility | None | $354.81 | $575.44 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $380.19 Typical High $478.63 | Facility | None | $346.74 | $380.19 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Denver HMP Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $478.63 | Facility | None | $338.84 | $338.84 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $676.08 | Professional | None | $251.19 | $371.54 | $676.08 |
Select Health Setting Facility Modifier None Typical Low $338.84 Median $616.60 Typical High $707.95 | Facility | None | $338.84 | $616.60 | $707.95 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $338.84 | Professional | None | $234.42 | $234.42 | $338.84 |
United Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
United Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
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 $169.82 Median $169.82 Typical High $331.13 | Professional | 52 · Reduced service | $169.82 | $169.82 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $131.83 | Professional | 53 · Discontinued | $67.61 | $67.61 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $97.72 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $66.07 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $66.07 |
Where Colorado sits
The same service costs 1.5 times more in Arizona than in Rhode Island. 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· 5th of 51
$407
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.