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 $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $26.92 Typical High $28.18 | Professional | None | $21.38 | $26.92 | $28.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $34.67 Typical High $48.98 | Professional | None | $26.30 | $34.67 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Denver HMP Setting Facility Modifier None Typical Low $23.99 Median $32.36 Typical High $50.12 | Facility | None | $23.99 | $32.36 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $338.84 Typical High $346.74 | Professional | None | $154.88 | $338.84 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $38.02 Median $38.90 Typical High $45.71 | Professional | None | $38.02 | $38.90 | $45.71 |
United Setting Professional Modifier None Typical Low $25.12 Median $30.90 Typical High $45.71 | Professional | None | $25.12 | $30.90 | $45.71 |
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 $10.72 Median $13.49 Typical High $14.13 | Professional | 52 · Reduced service | $10.72 | $13.49 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $5.37 Typical High $5.62 | Professional | 53 · Discontinued | $4.27 | $5.37 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.98 Typical High $4.17 | Professional | 55 · Aftercare only | $3.16 | $3.98 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.69 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.14 | $2.69 | $2.82 |
Where Colorado sits
The same service costs 2.7 times more in Alaska than in Connecticut. 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· 17th of 51
$30.20
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.