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 $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $218.78 | Professional | None | $190.55 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $95.50 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $38.02 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $28.18 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $19.05 | $21.88 | $21.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $199.53 | Professional | None | $128.82 | $199.53 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $213.80 | Professional | None | $25.12 | $25.12 | $213.80 |
Denver HMP Setting Facility Modifier None Typical Low $194.98 Median $218.78 Typical High $281.84 | Facility | None | $194.98 | $218.78 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $457.09 | Professional | None | $223.87 | $295.12 | $457.09 |
Select Health Setting Facility Modifier None Typical Low $186.21 Median $416.87 Typical High $478.63 | Facility | None | $186.21 | $416.87 | $478.63 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $331.13 | Professional | None | $177.83 | $229.09 | $331.13 |
United Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
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 $169.82 Median $190.55 Typical High $223.87 | Professional | HO · Master's level | $169.82 | $190.55 | $223.87 |
Where Colorado sits
The same service costs 5.2 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· 5th of 51
$219
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.