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 $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $95.50 Typical High $95.50 | Professional | None | $83.18 | $95.50 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $186.21 | Professional | None | $100.00 | $131.83 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $162.18 | Professional | None | $97.72 | $114.82 | $162.18 |
Denver HMP Setting Facility Modifier None Typical Low $95.50 Median $109.65 Typical High $134.90 | Facility | None | $95.50 | $109.65 | $134.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $169.82 | Professional | None | $89.13 | $107.15 | $169.82 |
Select Health Setting Facility Modifier None Typical Low $61.66 Median $77.62 Typical High $162.18 | Facility | None | $61.66 | $77.62 | $162.18 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $123.03 | Professional | None | $72.44 | $85.11 | $123.03 |
United Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $173.78 | Professional | None | $89.13 | $114.82 | $173.78 |
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 $41.69 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $41.69 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $16.60 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.13 Typical High $14.45 | Professional | 55 · Aftercare only | $12.59 | $14.13 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.32 | $9.55 | $9.55 |
Where Colorado sits
The same service costs 3.1 times more in Alaska than in Florida. 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· 16th of 51
$117
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.