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 $109.65 Median $208.93 Typical High $446.68 | Facility | None | $109.65 | $208.93 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $208.93 | Professional | None | $109.65 | $109.65 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $117.49 Median $181.97 Typical High $309.03 | Facility | None | $117.49 | $181.97 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $123.03 Typical High $147.91 | Facility | None | $112.20 | $123.03 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Denver HMP Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $158.49 | Facility | None | $109.65 | $109.65 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $218.78 | Professional | None | $83.18 | $120.23 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $109.65 Median $204.17 Typical High $229.09 | Facility | None | $109.65 | $204.17 | $229.09 |
Select Health Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $109.65 | Professional | None | $77.62 | $77.62 | $109.65 |
United Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
United Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
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 $54.95 Median $54.95 Typical High $104.71 | Professional | 52 · Reduced service | $54.95 | $54.95 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $41.69 | Professional | 53 · Discontinued | $21.88 | $21.88 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $158.49 | Professional | 54 · Surgery only | $83.18 | $83.18 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $31.62 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $20.89 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $20.89 |
Where Colorado sits
The same service costs 5.0 times more in Alabama 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· 7th of 51
$132
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.