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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $67.61 | Professional | None | $51.29 | $64.57 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $120.23 | Professional | None | $64.57 | $83.18 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Denver HMP Setting Facility Modifier None Typical Low $58.88 Median $77.62 Typical High $120.23 | Facility | None | $58.88 | $77.62 | $120.23 |
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 $104.71 Median $123.03 Typical High $123.03 | Professional | None | $104.71 | $123.03 | $123.03 |
United Setting Professional Modifier None Typical Low $60.26 Median $74.13 Typical High $109.65 | Professional | None | $60.26 | $74.13 | $109.65 |
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 $25.70 Median $32.36 Typical High $33.88 | Professional | 52 · Reduced service | $25.70 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $12.88 Typical High $13.49 | Professional | 53 · Discontinued | $10.23 | $12.88 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $9.77 Typical High $10.23 | Professional | 55 · Aftercare only | $7.59 | $9.77 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.46 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.13 | $6.46 | $6.76 |
Where Colorado sits
The same service costs 3.0 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
$74.13
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.