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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $87.10 | Professional | None | $77.62 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $38.90 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $15.49 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $11.48 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.76 | $8.71 | $8.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $173.78 | Professional | None | $79.43 | $109.65 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $123.03 | Professional | None | $74.13 | $74.13 | $123.03 |
Denver HMP Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $125.89 | Facility | None | $75.86 | $87.10 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $165.96 | Professional | None | $83.18 | $104.71 | $165.96 |
Select Health Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $173.78 | Facility | None | $83.18 | $83.18 | $173.78 |
Select Health Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $120.23 | Professional | None | $64.57 | $81.28 | $120.23 |
United Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $181.97 | Professional | None | $89.13 | $117.49 | $181.97 |
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 $61.66 Median $70.79 Typical High $83.18 | Professional | HO · Master's level | $61.66 | $70.79 | $83.18 |
Where Colorado sits
The same service costs 2.2 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· 20th of 51
$87.10
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.