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 $295.12 Median $426.58 Typical High $912.01 | Facility | None | $295.12 | $426.58 | $912.01 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $426.58 | Professional | None | $295.12 | $295.12 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $316.23 Median $489.78 Typical High $831.76 | Facility | None | $316.23 | $489.78 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $331.13 Typical High $489.78 | Facility | None | $302.00 | $331.13 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Denver HMP Setting Facility Modifier None Typical Low $3.39 Median $295.12 Typical High $426.58 | Facility | None | $3.39 | $295.12 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $524.81 | Professional | None | $223.87 | $323.59 | $524.81 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $549.54 Typical High $616.60 | Facility | None | $295.12 | $549.54 | $616.60 |
Select Health Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $295.12 | Professional | None | $208.93 | $208.93 | $295.12 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
United Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
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 $147.91 Median $147.91 Typical High $213.80 | Professional | 52 · Reduced service | $147.91 | $147.91 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $85.11 | Professional | 53 · Discontinued | $58.88 | $58.88 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $64.57 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $42.66 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $42.66 |
Where Colorado sits
The same service costs 6.8 times more in Wyoming than in Oklahoma. 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
$331
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.