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 $56.23 Median $109.65 Typical High $234.42 | Facility | None | $56.23 | $109.65 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $72.44 | Professional | None | $56.23 | $56.23 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $63.10 Median $97.72 Typical High $169.82 | Facility | None | $63.10 | $97.72 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $64.57 Typical High $79.43 | Facility | None | $57.54 | $64.57 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Denver HMP Setting Facility Modifier None Typical Low $28.84 Median $56.23 Typical High $81.28 | Facility | None | $28.84 | $56.23 | $81.28 |
Denver HMP Setting Professional Modifier None Typical Low $57.54 Median $60.26 Typical High $63.10 | Professional | None | $57.54 | $60.26 | $63.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $63.10 Typical High $93.33 | Professional | None | $53.70 | $63.10 | $93.33 |
Select Health Setting Facility Modifier None Typical Low $56.23 Median $104.71 Typical High $120.23 | Facility | None | $56.23 | $104.71 | $120.23 |
Select Health Setting Professional Modifier None Typical Low $39.81 Median $54.95 Typical High $57.54 | Professional | None | $39.81 | $54.95 | $57.54 |
United Setting Professional Modifier None Typical Low $21.88 Median $54.95 Typical High $54.95 | Professional | None | $21.88 | $54.95 | $54.95 |
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 $28.18 Median $28.18 Typical High $36.31 | Professional | 52 · Reduced service | $28.18 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $14.45 | Professional | 53 · Discontinued | $11.48 | $11.48 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $10.96 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $7.24 |
Where Colorado sits
The same service costs 1.6 times more in Alaska than in Louisiana. 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· 4th of 51
$60.26
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.