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 $213.80 Median $426.58 Typical High $912.01 | Facility | None | $213.80 | $426.58 | $912.01 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | None | $213.80 | $213.80 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $363.08 Typical High $616.60 | Facility | None | $229.09 | $363.08 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $239.88 Typical High $302.00 | Facility | None | $218.78 | $239.88 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Denver HMP Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $309.03 | Facility | None | $213.80 | $213.80 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $426.58 | Professional | None | $158.49 | $234.42 | $426.58 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $398.11 Typical High $446.68 | Facility | None | $213.80 | $398.11 | $446.68 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $213.80 | Professional | None | $151.36 | $151.36 | $213.80 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
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 $107.15 Median $107.15 Typical High $158.49 | Professional | 52 · Reduced service | $107.15 | $107.15 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $63.10 | Professional | 53 · Discontinued | $42.66 | $42.66 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $46.77 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $31.62 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $31.62 |
Where Colorado sits
The same service costs 7.6 times more in Alabama than in New Mexico. 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· 6th of 51
$251
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.