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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $117.49 | Professional | None | $81.28 | $81.28 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $165.96 Typical High $239.88 | Facility | None | $134.90 | $165.96 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Denver HMP Setting Facility Modifier None Typical Low $81.28 Median $87.10 Typical High $177.83 | Facility | None | $81.28 | $87.10 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $257.04 | Professional | None | $134.90 | $177.83 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $134.90 Median $208.93 Typical High $281.84 | Facility | None | $134.90 | $208.93 | $281.84 |
Select Health Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $229.09 | Professional | None | $134.90 | $186.21 | $229.09 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $40.74 Median $40.74 Typical High $58.88 | Professional | 52 · Reduced service | $40.74 | $40.74 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $23.99 | Professional | 53 · Discontinued | $16.22 | $16.22 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $17.78 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $11.75 |
Where Colorado sits
The same service costs 5.5 times more in North Dakota 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· 42nd of 51
$126
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.