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 $208.93 Median $354.81 Typical High $794.33 | Facility | None | $208.93 | $354.81 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $288.40 | Professional | None | $208.93 | $208.93 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $218.78 Median $346.74 Typical High $588.84 | Facility | None | $218.78 | $346.74 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $295.12 Typical High $309.03 | Facility | None | $251.19 | $295.12 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Denver HMP Setting Facility Modifier None Typical Low $141.25 Median $208.93 Typical High $295.12 | Facility | None | $141.25 | $208.93 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $416.87 | Professional | None | $154.88 | $229.09 | $416.87 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $389.05 Typical High $436.52 | Facility | None | $208.93 | $389.05 | $436.52 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $208.93 | Professional | None | $144.54 | $144.54 | $208.93 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $208.93 | Professional | None | $186.21 | $186.21 | $208.93 |
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 $104.71 Median $104.71 Typical High $186.21 | Professional | 52 · Reduced service | $104.71 | $104.71 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $75.86 | Professional | 53 · Discontinued | $41.69 | $41.69 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $56.23 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $38.02 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $38.02 |
Where Colorado sits
The same service costs 28.2 times more in Alabama than in Rhode Island. 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
$263
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.