How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $11.22 Median $112.20 Typical High $281.84 | Facility | None | $11.22 | $112.20 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $9.77 Median $112.20 Typical High $173.78 | Professional | None | $9.77 | $112.20 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $263.03 | Professional | None | $134.90 | $181.97 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $275.42 | Professional | None | $158.49 | $199.53 | $275.42 |
Denver HMP Setting Facility Modifier None Typical Low $120.23 Median $190.55 Typical High $263.03 | Facility | None | $120.23 | $190.55 | $263.03 |
Denver HMP Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $302.00 | Professional | None | $154.88 | $204.17 | $302.00 |
Select Health Setting Facility Modifier None Typical Low $165.96 Median $269.15 Typical High $346.74 | Facility | None | $165.96 | $269.15 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $218.78 | Professional | None | $112.20 | $165.96 | $218.78 |
United Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $295.12 | Professional | None | $158.49 | $204.17 | $295.12 |
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 $56.23 Median $67.61 Typical High $81.28 | Professional | 52 · Reduced service | $56.23 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.42 Typical High $24.55 | Professional | 55 · Aftercare only | $16.60 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.49 Typical High $16.22 | Professional | 56 · Pre-op care only | $11.22 | $13.49 | $16.22 |
Kaiser Permanente Setting Professional Modifier HO · Master's level Typical Low $102.33 Median $123.03 Typical High $158.49 | Professional | HO · Master's level | $102.33 | $123.03 | $158.49 |
Where Colorado sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 27th of 51
$162
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.