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 $22.91 Median $32.36 Typical High $93.33 | Facility | None | $22.91 | $32.36 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $24.55 Typical High $36.31 | Professional | None | $22.91 | $24.55 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.70 Median $39.81 Typical High $69.18 | Facility | None | $25.70 | $39.81 | $69.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $26.30 Typical High $30.20 | Facility | None | $21.88 | $26.30 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Denver HMP Setting Facility Modifier None Typical Low $2.82 Median $22.91 Typical High $33.11 | Facility | None | $2.82 | $22.91 | $33.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $17.38 Median $25.12 Typical High $45.71 | Professional | None | $17.38 | $25.12 | $45.71 |
Select Health Setting Facility Modifier None Typical Low $22.91 Median $42.66 Typical High $48.98 | Facility | None | $22.91 | $42.66 | $48.98 |
Select Health Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $22.91 | Professional | None | $16.22 | $16.22 | $22.91 |
United Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
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 $11.48 Median $11.48 Typical High $21.88 | Professional | 52 · Reduced service | $11.48 | $11.48 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.57 Typical High $8.71 | Professional | 53 · Discontinued | $4.57 | $4.57 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.47 Typical High $6.61 | Professional | 55 · Aftercare only | $3.47 | $3.47 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.29 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.29 | $2.29 | $4.37 |
Where Colorado sits
The same service costs 2.0 times more in Minnesota than in Hawaii. 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· 4th of 51
$27.54
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.