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 $57.54 Median $131.83 Typical High $263.03 | Facility | None | $57.54 | $131.83 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $60.26 | Professional | None | $57.54 | $57.54 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $102.33 Typical High $181.97 | Facility | None | $67.61 | $102.33 | $181.97 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Denver HMP Setting Facility Modifier None Typical Low $57.54 Median $66.07 Typical High $93.33 | Facility | None | $57.54 | $66.07 | $93.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $346.74 | Professional | None | $154.88 | $169.82 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $70.79 | Professional | None | $64.57 | $64.57 | $70.79 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $28.84 Median $28.84 Typical High $30.20 | Professional | 52 · Reduced service | $28.84 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $12.02 | Professional | 53 · Discontinued | $11.48 | $11.48 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $8.91 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $6.03 |
Where Colorado sits
The same service costs 1.6 times more in Alaska than in Hawaii. 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· 36th of 51
$61.66
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.