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 $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $275.42 | Professional | None | $234.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $120.23 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $47.86 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $36.31 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $23.99 | $27.54 | $27.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $208.93 | Professional | None | $165.96 | $208.93 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $269.15 | Professional | None | $15.49 | $15.49 | $269.15 |
Denver HMP Setting Facility Modifier None Typical Low $251.19 Median $275.42 Typical High $346.74 | Facility | None | $251.19 | $275.42 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $562.34 | Professional | None | $281.84 | $363.08 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $524.81 Typical High $588.84 | Facility | None | $234.42 | $524.81 | $588.84 |
Select Health Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $407.38 | Professional | None | $218.78 | $288.40 | $407.38 |
United Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
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 $213.80 Median $239.88 Typical High $281.84 | Professional | HO · Master's level | $213.80 | $239.88 | $281.84 |
Where Colorado sits
The same service costs 6.3 times more in Alaska than in New York. 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· 4th of 51
$275
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.