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 $47.86 Median $47.86 Typical High $61.66 | Facility | None | $47.86 | $47.86 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $54.95 Typical High $61.66 | Professional | None | $47.86 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $27.54 Typical High $30.90 | Professional | 52 · Reduced service | $23.99 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.13 Typical High $9.12 | Professional | 55 · Aftercare only | $7.08 | $8.13 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.50 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.79 | $5.50 | $6.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $138.04 | Professional | None | $63.10 | $87.10 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $81.28 Typical High $114.82 | Professional | None | $66.07 | $81.28 | $114.82 |
Denver HMP Setting Facility Modifier None Typical Low $47.86 Median $72.44 Typical High $93.33 | Facility | None | $47.86 | $72.44 | $93.33 |
Denver HMP Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $47.86 Median $72.44 Typical High $125.89 | Professional | None | $47.86 | $72.44 | $125.89 |
Select Health Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $151.36 | Facility | None | $72.44 | $72.44 | $151.36 |
Select Health Setting Professional Modifier None Typical Low $38.90 Median $51.29 Typical High $72.44 | Professional | None | $38.90 | $51.29 | $72.44 |
United Setting Professional Modifier None Typical Low $61.66 Median $83.18 Typical High $131.83 | Professional | None | $61.66 | $83.18 | $131.83 |
2 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 |
|---|---|---|---|---|---|
Kaiser Permanente Setting Professional Modifier HN · Bachelor's level Typical Low $35.48 Median $50.12 Typical High $66.07 | Professional | HN · Bachelor's level | $35.48 | $50.12 | $66.07 |
Kaiser Permanente Setting Professional Modifier HO · Master's level Typical Low $35.48 Median $50.12 Typical High $70.79 | Professional | HO · Master's level | $35.48 | $50.12 | $70.79 |
Where Colorado sits
The same service costs 2.6 times more in Alaska than in Kentucky. 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
$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.