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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $43.65 | Professional | None | $42.66 | $42.66 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
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 $42.66 Median $47.86 Typical High $123.03 | Facility | None | $42.66 | $47.86 | $123.03 |
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 |
5 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 $21.38 Median $21.38 Typical High $21.88 | Professional | 52 · Reduced service | $21.38 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.71 | Professional | 53 · Discontinued | $8.51 | $8.51 | $8.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $31.62 Typical High $33.11 | Professional | 54 · Surgery only | $31.62 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.61 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.37 |
Where Colorado sits
The same service costs 6.3 times more in North Dakota 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· 41st of 51
$45.71
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.