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 $20.42 Median $64.57 Typical High $138.04 | Facility | None | $20.42 | $64.57 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $46.77 | Professional | None | $20.42 | $20.42 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.91 Median $34.67 Typical High $61.66 | Facility | None | $22.91 | $34.67 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $23.99 Median $28.84 Typical High $63.10 | Facility | None | $23.99 | $28.84 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Denver HMP Setting Facility Modifier None Typical Low $20.42 Median $22.39 Typical High $28.84 | Facility | None | $20.42 | $22.39 | $28.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.14 Median $22.39 Typical High $33.11 | Professional | None | $15.14 | $22.39 | $33.11 |
Select Health Setting Facility Modifier None Typical Low $20.42 Median $38.02 Typical High $42.66 | Facility | None | $20.42 | $38.02 | $42.66 |
Select Health Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $20.42 | Professional | None | $14.13 | $14.13 | $20.42 |
United Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
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 $10.23 Median $10.23 Typical High $32.36 | Professional | 52 · Reduced service | $10.23 | $10.23 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $12.88 | Professional | 53 · Discontinued | $4.07 | $4.07 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $9.55 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $6.46 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $6.46 |
Where Colorado sits
The same service costs 3.8 times more in Oklahoma than in Delaware. 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· 37th 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.