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 $18.62 Median $28.84 Typical High $77.62 | Facility | None | $18.62 | $28.84 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $19.05 Typical High $28.84 | Professional | None | $18.62 | $19.05 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.95 Median $31.62 Typical High $52.48 | Facility | None | $19.95 | $31.62 | $52.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $19.05 Median $20.89 Typical High $25.70 | Facility | None | $19.05 | $20.89 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Denver HMP Setting Facility Modifier None Typical Low $18.62 Median $20.42 Typical High $26.30 | Facility | None | $18.62 | $20.42 | $26.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $13.80 Median $20.42 Typical High $33.88 | Professional | None | $13.80 | $20.42 | $33.88 |
Select Health Setting Facility Modifier None Typical Low $18.62 Median $33.88 Typical High $38.90 | Facility | None | $18.62 | $33.88 | $38.90 |
Select Health Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $18.62 | Professional | None | $12.88 | $12.88 | $18.62 |
United Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
United Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
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 $9.33 Median $9.33 Typical High $18.20 | Professional | 52 · Reduced service | $9.33 | $9.33 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $7.24 | Professional | 53 · Discontinued | $3.72 | $3.72 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $5.50 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $3.63 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $3.63 |
Where Colorado sits
The same service costs 1.5 times more in Alaska 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· 6th of 51
$21.38
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.