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 $134.90 Median $181.97 Typical High $389.05 | Facility | None | $134.90 | $181.97 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $194.98 | Professional | None | $173.78 | $173.78 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $194.98 Median $295.12 Typical High $512.86 | Facility | None | $194.98 | $295.12 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $194.98 Typical High $218.78 | Facility | None | $128.82 | $194.98 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Denver HMP Setting Facility Modifier None Typical Low $8.91 Median $173.78 Typical High $245.47 | Facility | None | $8.91 | $173.78 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $346.74 | Professional | None | $128.82 | $190.55 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $316.23 Median $346.74 Typical High $363.08 | Facility | None | $316.23 | $346.74 | $363.08 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $173.78 | Professional | None | $120.23 | $120.23 | $173.78 |
United Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
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 $87.10 Median $87.10 Typical High $97.72 | Professional | 52 · Reduced service | $87.10 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $39.81 | Professional | 53 · Discontinued | $34.67 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $29.51 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $19.50 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $19.50 |
Where Colorado sits
The same service costs 3.2 times more in Wyoming 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· 2nd of 51
$195
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.