How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $83.18 Median $117.49 Typical High $181.97 | Facility | None | $83.18 | $117.49 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $134.90 | Professional | None | $83.18 | $102.33 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $229.09 | Professional | None | $100.00 | $144.54 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $181.97 | Professional | None | $81.28 | $117.49 | $181.97 |
Denver HMP Setting Facility Modifier None Typical Low $83.18 Median $120.23 Typical High $186.21 | Facility | None | $83.18 | $120.23 | $186.21 |
Denver HMP Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $213.80 | Professional | None | $91.20 | $138.04 | $213.80 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $263.03 | Facility | None | $125.89 | $151.36 | $263.03 |
Select Health Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $128.82 | Professional | None | $70.79 | $97.72 | $128.82 |
United Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $181.97 | Professional | None | $87.10 | $123.03 | $181.97 |
4 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 $41.69 Median $45.71 Typical High $58.88 | Professional | 52 · Reduced service | $41.69 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.49 Typical High $17.38 | Professional | 55 · Aftercare only | $12.59 | $13.49 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.12 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.32 | $9.12 | $11.75 |
Kaiser Permanente Setting Professional Modifier HO · Master's level Typical Low $56.23 Median $79.43 Typical High $120.23 | Professional | HO · Master's level | $56.23 | $79.43 | $120.23 |
Where Colorado sits
The same service costs 2.7 times more in Alaska than in Washington, DC. 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· 19th of 51
$123
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.