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 $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $93.33 | Professional | None | $3.02 | $3.02 | $93.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.51 Median $1.51 Typical High $46.77 | Professional | 52 · Reduced service | $1.51 | $1.51 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $154.88 | Professional | None | $125.89 | $125.89 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Denver HMP Setting Facility Modifier None Typical Low $100.00 Median $177.83 Typical High $338.84 | Facility | None | $100.00 | $177.83 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $346.74 | Professional | None | $154.88 | $154.88 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $134.90 Median $251.19 Typical High $281.84 | Facility | None | $134.90 | $251.19 | $281.84 |
Select Health Setting Professional Modifier None Typical Low $134.90 Median $141.25 Typical High $234.42 | Professional | None | $134.90 | $141.25 | $234.42 |
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 53 · Discontinued Typical Low $14.45 Median $19.95 Typical High $24.55 | Professional | 53 · Discontinued | $14.45 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.79 Typical High $18.20 | Professional | 55 · Aftercare only | $10.96 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.77 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.24 | $9.77 | $12.30 |
Where Colorado sits
The same service costs 83.2 times more in North Dakota than in Kansas. 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· 46th of 51
$75.86
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.