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 $10.00 Median $114.82 Typical High $131.83 | Facility | None | $10.00 | $114.82 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $114.82 Typical High $199.53 | Professional | None | $10.00 | $114.82 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $223.87 Typical High $288.40 | Professional | None | $134.90 | $223.87 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $275.42 | Professional | None | $162.18 | $208.93 | $275.42 |
Denver HMP Setting Facility Modifier None Typical Low $114.82 Median $165.96 Typical High $234.42 | Facility | None | $114.82 | $165.96 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $309.03 | Professional | None | $147.91 | $194.98 | $309.03 |
Select Health Setting Facility Modifier None Typical Low $141.25 Median $257.04 Typical High $295.12 | Facility | None | $141.25 | $257.04 | $295.12 |
Select Health Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $141.25 | Professional | None | $97.72 | $97.72 | $141.25 |
United Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $338.84 | Professional | None | $158.49 | $208.93 | $338.84 |
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 $57.54 Median $57.54 Typical High $81.28 | Professional | 52 · Reduced service | $57.54 | $57.54 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $24.55 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $16.22 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $16.22 |
Where Colorado sits
The same service costs 2.4 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· 17th of 51
$182
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.