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 $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $562.34 | Professional | None | $478.63 | $562.34 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,096.48 | Professional | None | $575.44 | $776.25 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $851.14 | Professional | None | $512.86 | $575.44 | $851.14 |
Denver HMP Setting Facility Modifier None Typical Low $512.86 Median $630.96 Typical High $812.83 | Facility | None | $512.86 | $630.96 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,202.26 | Professional | None | $630.96 | $758.58 | $1,202.26 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $549.54 Typical High $1,148.15 | Facility | None | $436.52 | $549.54 | $1,148.15 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $870.96 | Professional | None | $436.52 | $549.54 | $870.96 |
United Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $891.25 | Professional | None | $457.09 | $588.84 | $891.25 |
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 $239.88 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $239.88 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $95.50 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $70.79 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $47.86 | $56.23 | $56.23 |
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
$676
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.