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 $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | None | $208.93 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $102.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $41.69 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $30.90 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $20.89 | $23.44 | $23.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $467.74 | Professional | None | $213.80 | $288.40 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $323.59 | Professional | None | $199.53 | $199.53 | $323.59 |
Denver HMP Setting Facility Modifier None Typical Low $204.17 Median $234.42 Typical High $331.13 | Facility | None | $204.17 | $234.42 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $446.68 | Professional | None | $223.87 | $281.84 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $467.74 | Facility | None | $223.87 | $223.87 | $467.74 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $323.59 | Professional | None | $169.82 | $213.80 | $323.59 |
United Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $478.63 | Professional | None | $234.42 | $309.03 | $478.63 |
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 $165.96 Median $186.21 Typical High $223.87 | Professional | HO · Master's level | $165.96 | $186.21 | $223.87 |
Where Colorado sits
The same service costs 2.2 times more in North Dakota 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· 15th of 51
$234
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.