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 $117.49 Median $213.80 Typical High $616.60 | Facility | None | $117.49 | $213.80 | $616.60 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $213.80 | Professional | None | $117.49 | $117.49 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $199.53 Typical High $354.81 | Facility | None | $131.83 | $199.53 | $354.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $131.83 Typical High $239.88 | Facility | None | $120.23 | $131.83 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Denver HMP Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $165.96 | Facility | None | $100.00 | $131.83 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $234.42 | Professional | None | $87.10 | $128.82 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $218.78 Typical High $245.47 | Facility | None | $117.49 | $218.78 | $245.47 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $117.49 | Professional | None | $81.28 | $81.28 | $117.49 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
United Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
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 $58.88 Median $58.88 Typical High $147.91 | Professional | 52 · Reduced service | $58.88 | $58.88 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $58.88 | Professional | 53 · Discontinued | $23.44 | $23.44 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $43.65 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $29.51 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $29.51 |
Where Colorado sits
The same service costs 2.0 times more in Kansas 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· 29th of 51
$148
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.