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 $128.82 Median $257.04 Typical High $549.54 | Facility | None | $128.82 | $257.04 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $131.83 Typical High $190.55 | Professional | None | $128.82 | $131.83 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $223.87 Typical High $371.54 | Facility | None | $138.04 | $223.87 | $371.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $147.91 Typical High $181.97 | Facility | None | $131.83 | $147.91 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Denver HMP Setting Facility Modifier None Typical Low $128.82 Median $144.54 Typical High $186.21 | Facility | None | $128.82 | $144.54 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $257.04 | Professional | None | $97.72 | $144.54 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $128.82 Median $239.88 Typical High $275.42 | Facility | None | $128.82 | $239.88 | $275.42 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $128.82 | Professional | None | $91.20 | $91.20 | $128.82 |
United Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
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 $64.57 Median $64.57 Typical High $128.82 | Professional | 52 · Reduced service | $64.57 | $64.57 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $52.48 | Professional | 53 · Discontinued | $25.70 | $25.70 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $38.90 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $25.70 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $25.70 |
Where Colorado sits
The same service costs 1.6 times more in Texas than in North Carolina. 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
$155
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.