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 $35.48 Median $89.13 Typical High $190.55 | Facility | None | $35.48 | $89.13 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $66.07 | Professional | None | $35.48 | $35.48 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $40.74 Median $63.10 Typical High $109.65 | Facility | None | $40.74 | $63.10 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Denver HMP Setting Facility Modifier None Typical Low $10.00 Median $35.48 Typical High $50.12 | Facility | None | $10.00 | $35.48 | $50.12 |
Select Health Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
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 $17.38 Median $17.38 Typical High $32.36 | Professional | 52 · Reduced service | $17.38 | $17.38 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $13.18 | Professional | 53 · Discontinued | $7.08 | $7.08 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $9.77 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $6.61 |
Where Colorado sits
The same service costs 8.1 times more in Kansas than in Hawaii. 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· 8th of 51
$45.71
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.