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 $5.25 Median $5.25 Typical High $6.46 | Facility | None | $5.25 | $5.25 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $5.25 Typical High $5.37 | Professional | None | $5.13 | $5.25 | $5.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | 52 · Reduced service | $2.63 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.05 Median $1.05 Typical High $1.05 | Professional | 53 · Discontinued | $1.05 | $1.05 | $1.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $0.78 Typical High $0.78 | Professional | 55 · Aftercare only | $0.78 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.68 Median $6.76 Typical High $12.02 | Professional | None | $4.68 | $6.76 | $12.02 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.98 Typical High $6.31 | Professional | None | $3.02 | $3.98 | $6.31 |
Denver HMP Setting Facility Modifier None Typical Low $5.25 Median $5.25 Typical High $7.41 | Facility | None | $5.25 | $5.25 | $7.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.25 Median $6.76 Typical High $10.96 | Professional | None | $5.25 | $6.76 | $10.96 |
Select Health Setting Facility Modifier None Typical Low $3.98 Median $9.77 Typical High $10.96 | Facility | None | $3.98 | $9.77 | $10.96 |
Select Health Setting Professional Modifier None Typical Low $3.89 Median $5.25 Typical High $7.59 | Professional | None | $3.89 | $5.25 | $7.59 |
United Setting Facility Modifier None Typical Low $162.18 Median $169.82 Typical High $194.98 | Facility | None | $162.18 | $169.82 | $194.98 |
United Setting Professional Modifier None Typical Low $4.79 Median $6.61 Typical High $10.72 | Professional | None | $4.79 | $6.61 | $10.72 |
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 |
|---|---|---|---|---|---|
Kaiser Permanente Setting Professional Modifier HO · Master's level Typical Low $3.89 Median $4.47 Typical High $5.25 | Professional | HO · Master's level | $3.89 | $4.47 | $5.25 |
Where Colorado sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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
$5.25
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.