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 $83.18 Median $165.96 Typical High $354.81 | Facility | None | $83.18 | $165.96 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $165.96 | Professional | None | $83.18 | $83.18 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $147.91 Typical High $257.04 | Facility | None | $97.72 | $147.91 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Denver HMP Setting Facility Modifier None Typical Low $83.18 Median $95.50 Typical High $125.89 | Facility | None | $83.18 | $95.50 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
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 $41.69 Median $41.69 Typical High $83.18 | Professional | 52 · Reduced service | $41.69 | $41.69 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $33.11 | Professional | 53 · Discontinued | $16.60 | $16.60 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $25.12 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $16.60 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $16.60 |
Where Colorado sits
The same service costs 1.6 times more in Alaska than in Texas. 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
$112
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.