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 $89.13 Median $186.21 Typical High $398.11 | Facility | None | $89.13 | $186.21 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $186.21 | Professional | None | $89.13 | $89.13 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $154.88 Typical High $269.15 | Facility | None | $97.72 | $154.88 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $102.33 Typical High $123.03 | Facility | None | $85.11 | $102.33 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Denver HMP Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $128.82 | Facility | None | $89.13 | $89.13 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $177.83 | Professional | None | $67.61 | $100.00 | $177.83 |
Select Health Setting Facility Modifier None Typical Low $89.13 Median $165.96 Typical High $190.55 | Facility | None | $89.13 | $165.96 | $190.55 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $89.13 | Professional | None | $63.10 | $63.10 | $89.13 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
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 $44.67 Median $44.67 Typical High $93.33 | Professional | 52 · Reduced service | $44.67 | $44.67 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $37.15 | Professional | 53 · Discontinued | $18.20 | $18.20 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $27.54 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $18.62 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $18.62 |
Where Colorado sits
The same service costs 5.9 times more in Alabama than in Florida. 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· 10th of 51
$112
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.