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 $42.66 Median $81.28 Typical High $173.78 | Facility | None | $42.66 | $81.28 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $81.28 | Professional | None | $42.66 | $42.66 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $45.71 Median $67.61 Typical High $117.49 | Facility | None | $45.71 | $67.61 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $47.86 Typical High $64.57 | Facility | None | $43.65 | $47.86 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Denver HMP Setting Facility Modifier None Typical Low $38.02 Median $42.66 Typical High $61.66 | Facility | None | $38.02 | $42.66 | $61.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $32.36 Median $46.77 Typical High $67.61 | Professional | None | $32.36 | $46.77 | $67.61 |
Select Health Setting Facility Modifier None Typical Low $42.66 Median $79.43 Typical High $89.13 | Facility | None | $42.66 | $79.43 | $89.13 |
Select Health Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $42.66 | Professional | None | $30.20 | $30.20 | $42.66 |
United Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
United Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
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 $21.38 Median $21.38 Typical High $40.74 | Professional | 52 · Reduced service | $21.38 | $21.38 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $16.22 | Professional | 53 · Discontinued | $8.51 | $8.51 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $12.02 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $8.13 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $8.13 |
Where Colorado sits
The same service costs 1.7 times more in Arizona than in Maryland. 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· 13th of 51
$47.86
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.