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 $776.25 Typical High $1,621.81 | Facility | None | $389.05 | $776.25 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $776.25 | Professional | None | $389.05 | $389.05 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $676.08 Typical High $1,122.02 | Facility | None | $416.87 | $676.08 | $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 $398.11 Median $446.68 Typical High $549.54 | Facility | None | $398.11 | $446.68 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Denver HMP Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $562.34 | Facility | None | $389.05 | $389.05 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $776.25 | Professional | None | $295.12 | $436.52 | $776.25 |
Select Health Setting Facility Modifier None Typical Low $389.05 Median $724.44 Typical High $831.76 | Facility | None | $389.05 | $724.44 | $831.76 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $389.05 | Professional | None | $275.42 | $275.42 | $389.05 |
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 $380.19 Median $380.19 Typical High $426.58 | Professional | None | $380.19 | $380.19 | $426.58 |
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 $380.19 | Professional | 52 · Reduced service | $194.98 | $194.98 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $154.88 | Professional | 53 · Discontinued | $79.43 | $79.43 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $114.82 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $77.62 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $77.62 |
Where Colorado sits
The same service costs 1.9 times more in Texas than in Illinois. 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
$479
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.