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 $389.05 Median $758.58 Typical High $1,621.81 | Facility | None | $389.05 | $758.58 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $758.58 | Professional | None | $389.05 | $389.05 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,096.48 | Facility | None | $407.38 | $645.65 | $1,096.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $549.54 Typical High $562.34 | Facility | None | $436.52 | $549.54 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Denver HMP Setting Facility Modifier None Typical Low $194.98 Median $389.05 Typical High $549.54 | Facility | None | $194.98 | $389.05 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $776.25 | Professional | None | $288.40 | $426.58 | $776.25 |
Select Health Setting Facility Modifier None Typical Low $389.05 Median $724.44 Typical High $812.83 | Facility | None | $389.05 | $724.44 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $389.05 | Professional | None | $269.15 | $269.15 | $389.05 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $426.58 | Professional | None | $380.19 | $380.19 | $426.58 |
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 $194.98 Median $194.98 Typical High $380.19 | Professional | 52 · Reduced service | $194.98 | $194.98 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $151.36 | Professional | 53 · Discontinued | $77.62 | $77.62 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $114.82 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $75.86 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $75.86 |
Where Colorado sits
The same service costs 11.5 times more in Alabama 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
$490
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.