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 $165.96 Median $257.04 Typical High $691.83 | Facility | None | $165.96 | $257.04 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $251.19 | Professional | None | $165.96 | $173.78 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $263.03 Typical High $524.81 | Facility | None | $177.83 | $263.03 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $186.21 Typical High $245.47 | Facility | None | $169.82 | $186.21 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Denver HMP Setting Facility Modifier None Typical Low $165.96 Median $186.21 Typical High $234.42 | Facility | None | $165.96 | $186.21 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $331.13 | Professional | None | $123.03 | $181.97 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $165.96 Median $309.03 Typical High $346.74 | Facility | None | $165.96 | $309.03 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $165.96 | Professional | None | $114.82 | $114.82 | $165.96 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
United Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
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 $83.18 Median $83.18 Typical High $162.18 | Professional | 52 · Reduced service | $83.18 | $83.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $66.07 | Professional | 53 · Discontinued | $33.11 | $33.11 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $48.98 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $32.36 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $32.36 |
Where Colorado sits
The same service costs 1.6 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· 6th of 51
$204
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.