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 $331.13 Median $331.13 Typical High $691.83 | Facility | None | $331.13 | $331.13 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $363.08 | Professional | None | $331.13 | $331.13 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $363.08 Typical High $870.96 | Professional | None | $218.78 | $363.08 | $870.96 |
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 $194.98 Median $380.19 Typical High $812.83 | Facility | None | $194.98 | $380.19 | $812.83 |
Denver HMP Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $891.25 Typical High $1,288.25 | Professional | None | $478.63 | $891.25 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $1,258.93 Typical High $1,445.44 | Facility | None | $676.08 | $1,258.93 | $1,445.44 |
Select Health Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Professional | None | $549.54 | $676.08 | $954.99 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $457.09 | Professional | None | $269.15 | $302.00 | $457.09 |
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 $165.96 Median $165.96 Typical High $181.97 | Professional | 52 · Reduced service | $165.96 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $72.44 | Professional | 53 · Discontinued | $66.07 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $53.70 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $36.31 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $36.31 |
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· 46th of 51
$331
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.