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 $53.70 Median $104.71 Typical High $218.78 | Facility | None | $53.70 | $104.71 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $54.95 Typical High $91.20 | Professional | None | $53.70 | $54.95 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $91.20 Typical High $162.18 | Facility | None | $60.26 | $91.20 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $60.26 Typical High $70.79 | Facility | None | $45.71 | $60.26 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Denver HMP Setting Facility Modifier None Typical Low $8.32 Median $53.70 Typical High $77.62 | Facility | None | $8.32 | $53.70 | $77.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $40.74 Median $58.88 Typical High $75.86 | Professional | None | $40.74 | $58.88 | $75.86 |
Select Health Setting Facility Modifier None Typical Low $53.70 Median $100.00 Typical High $112.20 | Facility | None | $53.70 | $100.00 | $112.20 |
Select Health Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $53.70 | Professional | None | $38.02 | $38.02 | $53.70 |
United Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
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 $26.92 Median $26.92 Typical High $45.71 | Professional | 52 · Reduced service | $26.92 | $26.92 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $18.20 | Professional | 53 · Discontinued | $10.72 | $10.72 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $13.80 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $9.12 |
Where Colorado sits
The same service costs 3.0 times more in Arizona than in Oklahoma. 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· 3rd of 51
$64.57
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.