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 $87.10 Median $97.72 Typical High $117.49 | Facility | None | $87.10 | $97.72 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $162.18 | Professional | None | $83.18 | $97.72 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $275.42 | Professional | None | $134.90 | $181.97 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $169.82 Typical High $229.09 | Professional | None | $93.33 | $169.82 | $229.09 |
Denver HMP Setting Facility Modifier None Typical Low $104.71 Median $117.49 Typical High $165.96 | Facility | None | $104.71 | $117.49 | $165.96 |
Denver HMP Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $169.82 Typical High $257.04 | Professional | None | $95.50 | $169.82 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $295.12 | Facility | None | $141.25 | $141.25 | $295.12 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $141.25 | Professional | None | $83.18 | $83.18 | $141.25 |
United Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $239.88 | Professional | None | $91.20 | $147.91 | $239.88 |
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 $46.77 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $46.77 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $14.13 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $9.33 | $11.75 | $11.75 |
Where Colorado sits
The same service costs 2.9 times more in Alaska than in Ohio. 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
$148
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.