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 $66.07 Median $66.07 Typical High $138.04 | Facility | None | $66.07 | $66.07 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $138.04 | Professional | None | $60.26 | $85.11 | $138.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $42.66 Typical High $67.61 | Professional | 52 · Reduced service | $30.20 | $42.66 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.98 Typical High $27.54 | Professional | 53 · Discontinued | $12.02 | $16.98 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.59 Typical High $20.42 | Professional | 55 · Aftercare only | $8.91 | $12.59 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.51 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.03 | $8.51 | $13.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $141.25 Typical High $281.84 | Professional | None | $70.79 | $141.25 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $97.72 Typical High $123.03 | Professional | None | $53.70 | $97.72 | $123.03 |
Denver HMP Setting Facility Modifier None Typical Low $66.07 Median $112.20 Typical High $194.98 | Facility | None | $66.07 | $112.20 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $128.82 Typical High $169.82 | Professional | None | $60.26 | $128.82 | $169.82 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $117.49 Typical High $245.47 | Facility | None | $100.00 | $117.49 | $245.47 |
Select Health Setting Professional Modifier None Typical Low $50.12 Median $63.10 Typical High $67.61 | Professional | None | $50.12 | $63.10 | $67.61 |
United Setting Facility Modifier None Typical Low $575.44 Median $616.60 Typical High $691.83 | Facility | None | $575.44 | $616.60 | $691.83 |
United Setting Professional Modifier None Typical Low $44.67 Median $77.62 Typical High $144.54 | Professional | None | $44.67 | $77.62 | $144.54 |
1 more rate 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Colorado sits
The same service costs 2.8 times more in Alaska than in Maryland. 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· 24th of 51
$91.20
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.