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 $147.91 Median $199.53 Typical High $575.44 | Facility | None | $147.91 | $199.53 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $169.82 | Professional | None | $147.91 | $147.91 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $158.49 Median $245.47 Typical High $426.58 | Facility | None | $158.49 | $245.47 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $208.93 Typical High $229.09 | Facility | None | $177.83 | $208.93 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Denver HMP Setting Facility Modifier None Typical Low $147.91 Median $165.96 Typical High $213.80 | Facility | None | $147.91 | $165.96 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $218.78 | Professional | None | $147.91 | $162.18 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $275.42 Typical High $316.23 | Facility | None | $147.91 | $275.42 | $316.23 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $213.80 | Professional | None | $147.91 | $147.91 | $213.80 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
United Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $144.54 | Professional | None | $134.90 | $134.90 | $144.54 |
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 $74.13 Median $74.13 Typical High $77.62 | Professional | 52 · Reduced service | $74.13 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $30.90 | Professional | 53 · Discontinued | $29.51 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $23.44 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $15.49 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $15.49 |
Where Colorado sits
The same service costs 2.4 times more in Wyoming than in New York. 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· 34th of 51
$148
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.