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 $32.36 Median $37.15 Typical High $43.65 | Facility | None | $32.36 | $37.15 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $43.65 Typical High $83.18 | Professional | None | $32.36 | $43.65 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $79.43 Typical High $102.33 | Professional | None | $58.88 | $79.43 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $50.12 Typical High $83.18 | Professional | None | $40.74 | $50.12 | $83.18 |
Denver HMP Setting Facility Modifier None Typical Low $40.74 Median $48.98 Typical High $61.66 | Facility | None | $40.74 | $48.98 | $61.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $61.66 Typical High $97.72 | Professional | None | $46.77 | $61.66 | $97.72 |
Select Health Setting Facility Modifier None Typical Low $44.67 Median $81.28 Typical High $93.33 | Facility | None | $44.67 | $81.28 | $93.33 |
Select Health Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $44.67 | Professional | None | $30.90 | $30.90 | $44.67 |
United Setting Professional Modifier None Typical Low $38.02 Median $51.29 Typical High $85.11 | Professional | None | $38.02 | $51.29 | $85.11 |
3 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 $16.98 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $16.98 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $5.13 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.47 | $4.37 | $4.37 |
Where Colorado sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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· 13th of 51
$63.10
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.