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 $74.13 Median $74.13 Typical High $85.11 | Facility | None | $74.13 | $74.13 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $75.86 Typical High $85.11 | Professional | None | $72.44 | $75.86 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $158.49 | Professional | None | $70.79 | $97.72 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $134.90 | Professional | None | $74.13 | $102.33 | $134.90 |
Denver HMP Setting Facility Modifier None Typical Low $74.13 Median $93.33 Typical High $120.23 | Facility | None | $74.13 | $93.33 | $120.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $123.03 | Professional | None | $58.88 | $81.28 | $123.03 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $169.82 | Facility | None | $117.49 | $117.49 | $169.82 |
Select Health Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $87.10 | Professional | None | $66.07 | $74.13 | $87.10 |
United Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
United Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $147.91 | Professional | None | $77.62 | $100.00 | $147.91 |
5 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 $36.31 Median $38.02 Typical High $42.66 | Professional | 52 · Reduced service | $36.31 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.14 Typical High $16.98 | Professional | 53 · Discontinued | $14.45 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $11.22 Typical High $12.88 | Professional | 55 · Aftercare only | $10.96 | $11.22 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.59 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.24 | $7.59 | $8.51 |
Kaiser Permanente Setting Professional Modifier HO · Master's level Typical Low $44.67 Median $61.66 Typical High $81.28 | Professional | HO · Master's level | $44.67 | $61.66 | $81.28 |
Where Colorado sits
The same service costs 8.1 times more in Alaska than in Indiana. 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· 17th 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.