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 $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $29.51 Typical High $29.51 | Professional | None | $25.70 | $29.51 | $29.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $41.69 Typical High $61.66 | Professional | None | $30.90 | $41.69 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $34.67 Typical High $58.88 | Professional | None | $29.51 | $34.67 | $58.88 |
Denver HMP Setting Facility Modifier None Typical Low $28.18 Median $37.15 Typical High $51.29 | Facility | None | $28.18 | $37.15 | $51.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $24.55 Median $37.15 Typical High $63.10 | Professional | None | $24.55 | $37.15 | $63.10 |
Select Health Setting Facility Modifier None Typical Low $28.84 Median $52.48 Typical High $60.26 | Facility | None | $28.84 | $52.48 | $60.26 |
Select Health Setting Professional Modifier None Typical Low $22.91 Median $28.18 Typical High $39.81 | Professional | None | $22.91 | $28.18 | $39.81 |
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 $27.54 Median $36.31 Typical High $53.70 | Professional | None | $27.54 | $36.31 | $53.70 |
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 $12.88 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $12.88 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $6.03 Typical High $6.03 | Professional | 53 · Discontinued | $5.13 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $3.89 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.57 | $2.95 | $2.95 |
Where Colorado sits
The same service costs 2.5 times more in Minnesota than in Arkansas. 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· 19th of 51
$38.02
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.