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 $602.56 Typical High $1,659.59 | Facility | None | $389.05 | $602.56 | $1,659.59 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $575.44 | Professional | None | $389.05 | $389.05 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $645.65 Typical High $1,122.02 | Facility | None | $416.87 | $645.65 | $1,122.02 |
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 $478.63 Median $549.54 Typical High $588.84 | Facility | None | $478.63 | $549.54 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $398.11 | Professional | None | $389.05 | $389.05 | $398.11 |
Denver HMP Setting Facility Modifier None Typical Low $158.49 Median $389.05 Typical High $562.34 | Facility | None | $158.49 | $389.05 | $562.34 |
Denver HMP Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $446.68 | Professional | None | $398.11 | $407.38 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $645.65 | Professional | None | $371.54 | $426.58 | $645.65 |
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 $275.42 Median $389.05 Typical High $416.87 | Professional | None | $275.42 | $389.05 | $416.87 |
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 $154.88 Median $389.05 Typical High $389.05 | Professional | None | $154.88 | $389.05 | $389.05 |
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 $257.04 | Professional | 52 · Reduced service | $194.98 | $194.98 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $102.33 | Professional | 53 · Discontinued | $77.62 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $77.62 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $51.29 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $51.29 |
Where Colorado sits
The same service costs 1.7 times more in Alaska 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· 10th of 51
$417
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.