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 $75.86 Median $75.86 Typical High $91.20 | Facility | None | $75.86 | $75.86 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $91.20 | Professional | None | $75.86 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $42.66 Typical High $45.71 | Professional | 52 · Reduced service | $38.02 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.59 Typical High $13.80 | Professional | 55 · Aftercare only | $11.22 | $12.59 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.51 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.59 | $8.51 | $9.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $208.93 | Professional | None | $95.50 | $131.83 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $173.78 | Professional | None | $100.00 | $125.89 | $173.78 |
Denver HMP Setting Facility Modifier None Typical Low $75.86 Median $107.15 Typical High $141.25 | Facility | None | $75.86 | $107.15 | $141.25 |
Denver HMP Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $190.55 | Professional | None | $74.13 | $112.20 | $190.55 |
Select Health Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $229.09 | Facility | None | $107.15 | $107.15 | $229.09 |
Select Health Setting Professional Modifier None Typical Low $61.66 Median $83.18 Typical High $107.15 | Professional | None | $61.66 | $83.18 | $107.15 |
United Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $204.17 | Professional | None | $100.00 | $125.89 | $204.17 |
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 $56.23 Median $79.43 Typical High $97.72 | Professional | HN · Bachelor's level | $56.23 | $79.43 | $97.72 |
Kaiser Permanente Setting Professional Modifier HO · Master's level Typical Low $56.23 Median $79.43 Typical High $107.15 | Professional | HO · Master's level | $56.23 | $79.43 | $107.15 |
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· 29th of 51
$91.20
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.