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 $16.22 Median $25.12 Typical High $58.88 | Facility | None | $16.22 | $25.12 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.98 Typical High $23.99 | Professional | None | $16.22 | $16.98 | $23.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $17.38 Median $26.30 Typical High $51.29 | Facility | None | $17.38 | $26.30 | $51.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $15.85 Typical High $28.84 | Facility | None | $13.18 | $15.85 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Denver HMP Setting Facility Modifier None Typical Low $16.22 Median $18.20 Typical High $22.91 | Facility | None | $16.22 | $18.20 | $22.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.02 Median $17.78 Typical High $26.30 | Professional | None | $12.02 | $17.78 | $26.30 |
Select Health Setting Facility Modifier None Typical Low $16.22 Median $30.20 Typical High $33.88 | Facility | None | $16.22 | $30.20 | $33.88 |
Select Health Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $16.22 | Professional | None | $11.22 | $11.22 | $16.22 |
United Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
United Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $15.14 | Professional | None | $13.80 | $13.80 | $15.14 |
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 $8.13 Median $8.13 Typical High $13.80 | Professional | 52 · Reduced service | $8.13 | $8.13 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $5.50 | Professional | 53 · Discontinued | $3.24 | $3.24 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $4.07 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $2.75 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $2.75 |
Where Colorado sits
The same service costs 5.9 times more in Wyoming than in North Dakota. 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· 8th of 51
$19.95
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.