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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $229.09 | Professional | None | $117.49 | $131.83 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $257.04 | Professional | None | $138.04 | $186.21 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $229.09 | Professional | None | $125.89 | $151.36 | $229.09 |
Denver HMP Setting Facility Modifier None Typical Low $131.83 Median $151.36 Typical High $190.55 | Facility | None | $131.83 | $151.36 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $234.42 | Professional | None | $123.03 | $151.36 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $85.11 Median $107.15 Typical High $223.87 | Facility | None | $85.11 | $107.15 | $223.87 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $169.82 | Professional | None | $100.00 | $117.49 | $169.82 |
United Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $239.88 | Professional | None | $123.03 | $154.88 | $239.88 |
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 $57.54 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $57.54 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $22.91 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $17.38 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $11.48 | $13.18 | $13.18 |
Where Colorado sits
The same service costs 3.2 times more in Alaska than in Utah. 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
$162
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.