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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $53.70 | Professional | None | $47.86 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $23.99 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $9.77 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $7.24 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.79 | $5.37 | $5.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $67.61 Typical High $107.15 | Professional | None | $48.98 | $67.61 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $75.86 | Professional | None | $45.71 | $45.71 | $75.86 |
Denver HMP Setting Facility Modifier None Typical Low $46.77 Median $53.70 Typical High $77.62 | Facility | None | $46.77 | $53.70 | $77.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $50.12 Median $64.57 Typical High $102.33 | Professional | None | $50.12 | $64.57 | $102.33 |
Select Health Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $107.15 | Facility | None | $50.12 | $50.12 | $107.15 |
Select Health Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $72.44 | Professional | None | $39.81 | $50.12 | $72.44 |
United Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $120.23 | Professional | None | $58.88 | $75.86 | $120.23 |
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 $38.02 Median $42.66 Typical High $50.12 | Professional | HO · Master's level | $38.02 | $42.66 | $50.12 |
Where Colorado sits
The same service costs 2.2 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· 24th of 51
$53.70
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.