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 $138.04 Median $138.04 Typical High $218.78 | Facility | None | $138.04 | $138.04 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $138.04 | Professional | None | $120.23 | $138.04 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $154.88 Typical High $257.04 | Professional | None | $85.11 | $154.88 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $218.78 | Professional | None | $134.90 | $177.83 | $218.78 |
Denver HMP Setting Facility Modifier None Typical Low $138.04 Median $173.78 Typical High $245.47 | Facility | None | $138.04 | $173.78 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $213.80 | Professional | None | $107.15 | $151.36 | $213.80 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $269.15 | Facility | None | $251.19 | $251.19 | $269.15 |
Select Health Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $177.83 | Professional | None | $123.03 | $131.83 | $177.83 |
United Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
United Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $245.47 | Professional | None | $134.90 | $169.82 | $245.47 |
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 $60.26 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $60.26 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $24.55 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $18.20 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $12.30 | $13.80 | $13.80 |
Where Colorado sits
The same service costs 2.8 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· 20th of 51
$155
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.