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 $22.39 Median $22.39 Typical High $91.20 | Facility | None | $22.39 | $22.39 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $54.95 Typical High $91.20 | Professional | None | $20.42 | $54.95 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.23 Median $27.54 Typical High $45.71 | Professional | 52 · Reduced service | $10.23 | $27.54 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $11.22 Typical High $18.20 | Professional | 53 · Discontinued | $4.07 | $11.22 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $8.32 Typical High $13.80 | Professional | 55 · Aftercare only | $3.09 | $8.32 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $5.62 Typical High $9.12 | Professional | 56 · Pre-op care only | $2.04 | $5.62 | $9.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $75.86 Typical High $194.98 | Professional | None | $23.99 | $75.86 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $54.95 Typical High $77.62 | Professional | None | $18.62 | $54.95 | $77.62 |
Denver HMP Setting Facility Modifier None Typical Low $22.39 Median $70.79 Typical High $128.82 | Facility | None | $22.39 | $70.79 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.38 Median $83.18 Typical High $120.23 | Professional | None | $21.38 | $83.18 | $120.23 |
Select Health Setting Facility Modifier None Typical Low $36.31 Median $83.18 Typical High $173.78 | Facility | None | $36.31 | $83.18 | $173.78 |
Select Health Setting Professional Modifier None Typical Low $20.42 Median $22.39 Typical High $24.55 | Professional | None | $20.42 | $22.39 | $24.55 |
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 $21.88 Median $35.48 Typical High $91.20 | Professional | None | $21.88 | $35.48 | $91.20 |
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 4.4 times more in Hawaii than in Washington, DC. 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
$50.12
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.