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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $144.54 Typical High $169.82 | Facility | None | $104.71 | $144.54 | $169.82 |
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 $87.10 Median $89.13 Typical High $128.82 | Facility | None | $87.10 | $89.13 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $257.04 | Professional | None | $131.83 | $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 $190.55 Typical High $234.42 | Professional | None | $134.90 | $190.55 | $234.42 |
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 $44.67 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $8.91 |
Where Colorado sits
The same service costs 2.1 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· 19th 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.