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 $131.83 Median $131.83 Typical High $199.53 | Facility | None | $131.83 | $131.83 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $158.49 | Professional | None | $131.83 | $131.83 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $141.25 Typical High $363.08 | Professional | None | $85.11 | $141.25 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | None | $165.96 | $165.96 | $194.98 |
Denver HMP Setting Facility Modifier None Typical Low $75.86 Median $151.36 Typical High $323.59 | Facility | None | $75.86 | $151.36 | $323.59 |
Denver HMP Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $354.81 Typical High $537.03 | Professional | None | $194.98 | $354.81 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $269.15 Median $501.19 Typical High $562.34 | Facility | None | $269.15 | $501.19 | $562.34 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $338.84 | Professional | None | $190.55 | $269.15 | $338.84 |
United Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $181.97 | Professional | None | $107.15 | $117.49 | $181.97 |
2 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 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $21.38 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $14.13 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $14.13 |
Where Colorado sits
The same service costs 2.6 times more in Montana than in New York. 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· 27th of 51
$166
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.