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 $281.84 Median $281.84 Typical High $436.52 | Facility | None | $281.84 | $281.84 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $281.84 | Professional | None | $239.88 | $281.84 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $251.19 Typical High $575.44 | Professional | None | $138.04 | $251.19 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
Denver HMP Setting Facility Modifier None Typical Low $134.90 Median $281.84 Typical High $630.96 | Facility | None | $134.90 | $281.84 | $630.96 |
Denver HMP Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $741.31 Typical High $1,148.15 | Professional | None | $398.11 | $741.31 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $1,047.13 Typical High $1,202.26 | Facility | None | $575.44 | $1,047.13 | $1,202.26 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $794.33 | Professional | None | $398.11 | $575.44 | $794.33 |
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 $190.55 Median $208.93 Typical High $323.59 | Professional | None | $190.55 | $208.93 | $323.59 |
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 $120.23 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $120.23 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $47.86 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $36.31 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $23.99 | $28.18 | $28.18 |
Where Colorado sits
The same service costs 3.4 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· 29th of 51
$316
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.