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 $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | None | $93.33 | $97.72 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $199.53 | Professional | None | $100.00 | $138.04 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Denver HMP Setting Facility Modifier None Typical Low $97.72 Median $123.03 Typical High $158.49 | Facility | None | $97.72 | $123.03 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $204.17 | Professional | None | $100.00 | $134.90 | $204.17 |
Select Health Setting Facility Modifier None Typical Low $186.21 Median $199.53 Typical High $208.93 | Facility | None | $186.21 | $199.53 | $208.93 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $158.49 | Professional | None | $81.28 | $100.00 | $158.49 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $154.88 | Professional | None | $91.20 | $107.15 | $154.88 |
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 $45.71 Median $47.86 Typical High $48.98 | Professional | 52 · Reduced service | $45.71 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $18.62 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.45 Typical High $14.79 | Professional | 55 · Aftercare only | $13.80 | $14.45 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.55 Typical High $9.77 | Professional | 56 · Pre-op care only | $9.33 | $9.55 | $9.77 |
Where Colorado sits
The same service costs 3.3 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· 10th of 51
$120
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.