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 $17.78 Median $19.50 Typical High $51.29 | Facility | None | $17.78 | $19.50 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $25.70 | Professional | None | $19.05 | $19.05 | $25.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $21.38 Median $32.36 Typical High $56.23 | Facility | None | $21.38 | $32.36 | $56.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $15.14 Median $21.38 Typical High $25.12 | Facility | None | $15.14 | $21.38 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Denver HMP Setting Facility Modifier None Typical Low $16.98 Median $19.05 Typical High $26.92 | Facility | None | $16.98 | $19.05 | $26.92 |
Kaiser Permanente Setting Professional Modifier None Typical Low $14.13 Median $20.89 Typical High $38.02 | Professional | None | $14.13 | $20.89 | $38.02 |
Select Health Setting Facility Modifier None Typical Low $19.05 Median $34.67 Typical High $39.81 | Facility | None | $19.05 | $34.67 | $39.81 |
Select Health Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $19.05 | Professional | None | $13.18 | $13.18 | $19.05 |
United Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
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 $9.55 Median $9.55 Typical High $12.88 | Professional | 52 · Reduced service | $9.55 | $9.55 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $5.13 | Professional | 53 · Discontinued | $3.80 | $3.80 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $3.89 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $2.57 | Professional | 56 · Pre-op care only | $1.91 | $1.91 | $2.57 |
Where Colorado sits
The same service costs 2.7 times more in Wyoming than in Iowa. 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· 3rd of 51
$21.38
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.