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 $69.18 Median $93.33 Typical High $199.53 | Facility | None | $69.18 | $93.33 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $102.33 | Professional | None | $77.62 | $77.62 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $131.83 Typical High $234.42 | Facility | None | $87.10 | $131.83 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $87.10 Typical High $109.65 | Facility | None | $74.13 | $87.10 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Denver HMP Setting Facility Modifier None Typical Low $77.62 Median $102.33 Typical High $389.05 | Facility | None | $77.62 | $102.33 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $58.88 Median $85.11 Typical High $154.88 | Professional | None | $58.88 | $85.11 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $77.62 Median $144.54 Typical High $162.18 | Facility | None | $77.62 | $144.54 | $162.18 |
Select Health Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $77.62 | Professional | None | $54.95 | $54.95 | $77.62 |
United Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
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 $38.90 Median $38.90 Typical High $50.12 | Professional | 52 · Reduced service | $38.90 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $20.42 | Professional | 53 · Discontinued | $15.49 | $15.49 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $15.14 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $10.23 |
Where Colorado sits
The same service costs 3.6 times more in Texas than in Kansas. 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
$93.33
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.