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 $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $177.83 | Professional | None | $162.18 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $81.28 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $32.36 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $23.99 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $16.22 | $17.78 | $17.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $354.81 | Professional | None | $162.18 | $223.87 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $251.19 | Professional | None | $151.36 | $151.36 | $251.19 |
Denver HMP Setting Facility Modifier None Typical Low $154.88 Median $177.83 Typical High $251.19 | Facility | None | $154.88 | $177.83 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $338.84 | Professional | None | $165.96 | $213.80 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $346.74 | Facility | None | $165.96 | $165.96 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $162.18 Typical High $239.88 | Professional | None | $131.83 | $162.18 | $239.88 |
United Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $398.11 | Professional | None | $194.98 | $251.19 | $398.11 |
1 more rate 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 HO · Master's level Typical Low $125.89 Median $141.25 Typical High $165.96 | Professional | HO · Master's level | $125.89 | $141.25 | $165.96 |
Where Colorado sits
The same service costs 2.3 times more in Alaska than in Arizona. 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· 22nd of 51
$178
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.