How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $22.91 Typical High $24.55 | Professional | None | $19.95 | $22.91 | $24.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $39.81 Typical High $61.66 | Professional | None | $28.84 | $39.81 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Denver HMP Setting Facility Modifier None Typical Low $17.78 Median $25.12 Typical High $33.11 | Facility | None | $17.78 | $25.12 | $33.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.84 Median $40.74 Typical High $60.26 | Professional | None | $28.84 | $40.74 | $60.26 |
Select Health Setting Facility Modifier None Typical Low $27.54 Median $50.12 Typical High $57.54 | Facility | None | $27.54 | $50.12 | $57.54 |
Select Health Setting Professional Modifier None Typical Low $21.88 Median $27.54 Typical High $53.70 | Professional | None | $21.88 | $27.54 | $53.70 |
United Setting Professional Modifier None Typical Low $19.50 Median $30.20 Typical High $52.48 | Professional | None | $19.50 | $30.20 | $52.48 |
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 $10.00 Median $11.48 Typical High $12.30 | Professional | 52 · Reduced service | $10.00 | $11.48 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.57 Typical High $4.90 | Professional | 53 · Discontinued | $4.07 | $4.57 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.47 Typical High $3.63 | Professional | 55 · Aftercare only | $3.02 | $3.47 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.29 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.04 | $2.29 | $2.45 |
Where Colorado sits
The same service costs 4.1 times more in Wyoming than in Kentucky. 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· 15th of 51
$34.67
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.