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 $512.86 Median $1,000.00 Typical High $2,089.30 | Facility | None | $512.86 | $1,000.00 | $2,089.30 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,000.00 | Professional | None | $512.86 | $512.86 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $870.96 Typical High $1,445.44 | Facility | None | $537.03 | $870.96 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $575.44 Typical High $724.44 | Facility | None | $524.81 | $575.44 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Denver HMP Setting Facility Modifier None Typical Low $512.86 Median $562.34 Typical High $724.44 | Facility | None | $512.86 | $562.34 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $1,023.29 | Professional | None | $380.19 | $562.34 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $954.99 Typical High $1,071.52 | Facility | None | $512.86 | $954.99 | $1,071.52 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $512.86 | Professional | None | $354.81 | $354.81 | $512.86 |
United Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
United Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
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 $257.04 Median $257.04 Typical High $501.19 | Professional | 52 · Reduced service | $257.04 | $257.04 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $199.53 | Professional | 53 · Discontinued | $102.33 | $102.33 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $147.91 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $100.00 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $100.00 |
Where Colorado sits
The same service costs 2.8 times more in Arizona 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· 5th of 51
$617
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.