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 $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $263.03 | Professional | None | $158.49 | $263.03 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $407.38 | Professional | None | $234.42 | $295.12 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Denver HMP Setting Facility Modifier None Typical Low $234.42 Median $263.03 Typical High $371.54 | Facility | None | $234.42 | $263.03 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $309.03 | Professional | None | $154.88 | $194.98 | $309.03 |
Select Health Setting Facility Modifier None Typical Low $141.25 Median $263.03 Typical High $295.12 | Facility | None | $141.25 | $263.03 | $295.12 |
Select Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $223.87 | Professional | None | $141.25 | $141.25 | $223.87 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $1,737.80 | Facility | None | $1,445.44 | $1,513.56 | $1,737.80 |
United Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $371.54 | Professional | None | $194.98 | $257.04 | $371.54 |
4 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 52 · Reduced service Typical Low $79.43 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $79.43 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $31.62 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $23.44 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $15.85 | $26.30 | $26.30 |
Where Colorado sits
The same service costs 3.2 times more in Alaska than in Connecticut. 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· 12th of 51
$263
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.