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 $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $10.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $275.42 | Professional | None | $125.89 | $173.78 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $194.98 | Professional | None | $120.23 | $120.23 | $194.98 |
Denver HMP Setting Facility Modifier None Typical Low $109.65 Median $138.04 Typical High $162.18 | Facility | None | $109.65 | $138.04 | $162.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $269.15 | Professional | None | $131.83 | $169.82 | $269.15 |
Select Health Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $275.42 | Facility | None | $131.83 | $131.83 | $275.42 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $190.55 | Professional | None | $100.00 | $125.89 | $190.55 |
United Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $275.42 | Professional | None | $138.04 | $181.97 | $275.42 |
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 $97.72 Median $112.20 Typical High $131.83 | Professional | HO · Master's level | $97.72 | $112.20 | $131.83 |
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· 36th of 51
$112
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.