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 $144.54 Median $281.84 Typical High $602.56 | Facility | None | $144.54 | $281.84 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $281.84 | Professional | None | $144.54 | $144.54 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $154.88 Median $251.19 Typical High $416.87 | Facility | None | $154.88 | $251.19 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $165.96 Typical High $204.17 | Facility | None | $147.91 | $165.96 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Denver HMP Setting Facility Modifier None Typical Low $144.54 Median $162.18 Typical High $208.93 | Facility | None | $144.54 | $162.18 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $288.40 | Professional | None | $109.65 | $158.49 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $269.15 Typical High $302.00 | Facility | None | $144.54 | $269.15 | $302.00 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $144.54 | Professional | None | $102.33 | $102.33 | $144.54 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $154.88 | Professional | None | $141.25 | $141.25 | $154.88 |
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 $72.44 Median $72.44 Typical High $141.25 | Professional | 52 · Reduced service | $72.44 | $72.44 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $56.23 | Professional | 53 · Discontinued | $28.84 | $28.84 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $42.66 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $28.18 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $28.18 |
Where Colorado sits
The same service costs 1.5 times more in Arizona than in Oregon. 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
$174
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.