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 $12.02 Median $16.60 Typical High $52.48 | Facility | None | $12.02 | $16.60 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $18.20 | Professional | None | $12.02 | $12.02 | $18.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.49 Median $20.42 Typical High $36.31 | Facility | None | $13.49 | $20.42 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $16.98 Typical High $18.20 | Facility | None | $13.18 | $16.98 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Denver HMP Setting Facility Modifier None Typical Low $12.02 Median $15.85 Typical High $43.65 | Facility | None | $12.02 | $15.85 | $43.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9.12 Median $13.18 Typical High $19.50 | Professional | None | $9.12 | $13.18 | $19.50 |
Select Health Setting Facility Modifier None Typical Low $12.02 Median $22.39 Typical High $25.12 | Facility | None | $12.02 | $22.39 | $25.12 |
Select Health Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $12.02 | Professional | None | $8.51 | $8.51 | $12.02 |
United Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $18.62 | Professional | None | $12.30 | $12.30 | $18.62 |
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 $6.03 Median $6.03 Typical High $12.30 | Professional | 52 · Reduced service | $6.03 | $6.03 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.40 Typical High $5.01 | Professional | 53 · Discontinued | $2.40 | $2.40 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $3.72 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $2.45 | Professional | 56 · Pre-op care only | $1.20 | $1.20 | $2.45 |
Where Colorado sits
The same service costs 1.9 times more in Alaska than in Pennsylvania. 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· 6th of 51
$15.85
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.