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 $41.69 Median $72.44 Typical High $213.80 | Facility | None | $41.69 | $72.44 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $57.54 | Professional | None | $41.69 | $41.69 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $46.77 Median $70.79 Typical High $123.03 | Facility | None | $46.77 | $70.79 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $58.88 Typical High $158.49 | Facility | None | $52.48 | $58.88 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Denver HMP Setting Facility Modifier None Typical Low $41.69 Median $54.95 Typical High $346.74 | Facility | None | $41.69 | $54.95 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $30.90 Median $45.71 Typical High $67.61 | Professional | None | $30.90 | $45.71 | $67.61 |
Select Health Setting Facility Modifier None Typical Low $41.69 Median $75.86 Typical High $87.10 | Facility | None | $41.69 | $75.86 | $87.10 |
Select Health Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $41.69 | Professional | None | $28.84 | $28.84 | $41.69 |
United Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
United Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $54.95 | Professional | None | $50.12 | $50.12 | $54.95 |
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 $20.89 Median $20.89 Typical High $36.31 | Professional | 52 · Reduced service | $20.89 | $20.89 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $19.95 | Professional | 53 · Discontinued | $8.32 | $8.32 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $14.79 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $10.00 |
Where Colorado sits
The same service costs 3.9 times more in Wyoming than in Georgia. 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· 16th of 51
$53.70
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.