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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $151.36 | Professional | None | $141.25 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $70.79 Typical High $75.86 | Professional | 52 · Reduced service | $70.79 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $30.20 | Professional | 53 · Discontinued | $28.18 | $28.18 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $22.91 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $15.14 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $15.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $354.81 | Professional | None | $165.96 | $229.09 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
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 $141.25 Median $181.97 Typical High $213.80 | Facility | None | $141.25 | $181.97 | $213.80 |
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 2.6 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· 39th of 51
$151
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.