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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,412.54 | Professional | None | $1,318.26 | $1,318.26 | $1,412.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,412.54 Typical High $3,548.13 | Professional | None | $851.14 | $1,412.54 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
Denver HMP Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $3,162.28 | Facility | None | $758.58 | $1,513.56 | $3,162.28 |
Denver HMP Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,905.46 Median $3,548.13 Typical High $5,370.32 | Professional | None | $1,905.46 | $3,548.13 | $5,370.32 |
Select Health Setting Facility Modifier None Typical Low $2,691.53 Median $5,011.87 Typical High $5,623.41 | Facility | None | $2,691.53 | $5,011.87 | $5,623.41 |
Select Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $3,388.44 | Professional | None | $1,905.46 | $2,691.53 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,174.90 | $1,819.70 |
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 $660.69 Median $660.69 Typical High $707.95 | Professional | 52 · Reduced service | $660.69 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $288.40 | Professional | 53 · Discontinued | $263.03 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $213.80 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $141.25 |
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· 43rd of 51
$1,318
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.