How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $257.04 Typical High $257.04 | Professional | None | $77.62 | $257.04 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $147.91 | Professional | None | $81.28 | $107.15 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Denver HMP Setting Facility Modifier None Typical Low $95.50 Median $257.04 Typical High $363.08 | Facility | None | $95.50 | $257.04 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $346.74 Typical High $1,023.29 | Professional | None | $154.88 | $346.74 | $1,023.29 |
Select Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
United Setting Facility Modifier None Typical Low $6,760.83 Median $7,079.46 Typical High $8,128.31 | Facility | None | $6,760.83 | $7,079.46 | $8,128.31 |
United Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $177.83 | Professional | None | $89.13 | $117.49 | $177.83 |
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 $38.90 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $38.90 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $15.49 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $11.75 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $7.76 | $25.70 | $25.70 |
Where Colorado sits
The same service costs 3.2 times more in Alaska 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· 15th of 51
$115
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.