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 $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $537.03 | Professional | None | $457.09 | $537.03 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,047.13 | Professional | None | $562.34 | $741.31 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $812.83 | Professional | None | $489.78 | $549.54 | $812.83 |
Denver HMP Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $776.25 | Facility | None | $489.78 | $602.56 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,174.90 | Professional | None | $602.56 | $741.31 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $524.81 Typical High $1,122.02 | Facility | None | $426.58 | $524.81 | $1,122.02 |
Select Health Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $831.76 | Professional | None | $416.87 | $524.81 | $831.76 |
United Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $851.14 | Professional | None | $436.52 | $562.34 | $851.14 |
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 $229.09 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $229.09 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $91.20 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $69.18 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $45.71 | $53.70 | $53.70 |
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
$661
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.