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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $53.70 Typical High $64.57 | Professional | None | $42.66 | $53.70 | $64.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $100.00 | Professional | None | $53.70 | $69.18 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Denver HMP Setting Facility Modifier None Typical Low $48.98 Median $64.57 Typical High $104.71 | Facility | None | $48.98 | $64.57 | $104.71 |
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 $114.82 Median $117.49 Typical High $138.04 | Professional | None | $114.82 | $117.49 | $138.04 |
United Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $91.20 | Professional | None | $50.12 | $61.66 | $91.20 |
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 $21.38 Median $26.92 Typical High $32.36 | Professional | 52 · Reduced service | $21.38 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $10.72 Typical High $12.88 | Professional | 53 · Discontinued | $8.51 | $10.72 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $8.13 Typical High $9.55 | Professional | 55 · Aftercare only | $6.46 | $8.13 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $5.37 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.27 | $5.37 | $6.46 |
Where Colorado sits
The same service costs 4.0 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
$61.66
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.