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 $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $363.08 | Professional | None | $245.47 | $323.59 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $616.60 | Professional | None | $323.59 | $446.68 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $467.74 | Professional | None | $263.03 | $295.12 | $467.74 |
Denver HMP Setting Facility Modifier None Typical Low $288.40 Median $323.59 Typical High $457.09 | Facility | None | $288.40 | $323.59 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $691.83 | Professional | None | $363.08 | $436.52 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $316.23 Typical High $660.69 | Facility | None | $251.19 | $316.23 | $660.69 |
Select Health Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $501.19 | Professional | None | $245.47 | $316.23 | $501.19 |
United Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $467.74 | Professional | None | $234.42 | $302.00 | $467.74 |
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 $134.90 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $134.90 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $53.70 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $39.81 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $26.92 | $32.36 | $32.36 |
Where Colorado sits
The same service costs 2.8 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
$380
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.