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 $32.36 Typical High $33.88 | Facility | None | $32.36 | $32.36 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $51.29 | Professional | None | $32.36 | $33.88 | $51.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $70.79 Typical High $95.50 | Professional | None | $51.29 | $70.79 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $66.07 Typical High $89.13 | Professional | None | $44.67 | $66.07 | $89.13 |
Denver HMP Setting Facility Modifier None Typical Low $32.36 Median $44.67 Typical High $72.44 | Facility | None | $32.36 | $44.67 | $72.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.02 Median $51.29 Typical High $83.18 | Professional | None | $38.02 | $51.29 | $83.18 |
Select Health Setting Facility Modifier None Typical Low $39.81 Median $66.07 Typical High $83.18 | Facility | None | $39.81 | $66.07 | $83.18 |
Select Health Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $39.81 | Professional | None | $22.91 | $22.91 | $39.81 |
United Setting Professional Modifier None Typical Low $47.86 Median $64.57 Typical High $107.15 | Professional | None | $47.86 | $64.57 | $107.15 |
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 $16.22 Median $16.98 Typical High $21.38 | Professional | 52 · Reduced service | $16.22 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $5.13 Typical High $6.46 | Professional | 55 · Aftercare only | $4.79 | $5.13 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.39 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.24 | $3.39 | $4.27 |
Where Colorado sits
The same service costs 2.6 times more in Nebraska than in Texas. 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
$61.66
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.