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 $107.15 Median $107.15 Typical High $141.25 | Facility | None | $107.15 | $107.15 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $141.25 | Professional | None | $107.15 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $54.95 Typical High $70.79 | Professional | 52 · Reduced service | $53.70 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.88 Typical High $28.84 | Professional | 53 · Discontinued | $21.38 | $21.88 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $21.38 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.96 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.72 | $10.96 | $14.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $263.03 | Professional | None | $120.23 | $169.82 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $251.19 | Professional | None | $154.88 | $154.88 | $251.19 |
Denver HMP Setting Facility Modifier None Typical Low $107.15 Median $141.25 Typical High $204.17 | Facility | None | $107.15 | $141.25 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $281.84 | Professional | None | $102.33 | $173.78 | $281.84 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $363.08 | Facility | None | $173.78 | $173.78 | $363.08 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $173.78 | Professional | None | $85.11 | $123.03 | $173.78 |
United Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $251.19 | Professional | None | $125.89 | $162.18 | $251.19 |
2 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 |
|---|---|---|---|---|---|
Kaiser Permanente Setting Professional Modifier HN · Bachelor's level Typical Low $77.62 Median $109.65 Typical High $158.49 | Professional | HN · Bachelor's level | $77.62 | $109.65 | $158.49 |
Kaiser Permanente Setting Professional Modifier HO · Master's level Typical Low $77.62 Median $109.65 Typical High $169.82 | Professional | HO · Master's level | $77.62 | $109.65 | $169.82 |
Where Colorado sits
The same service costs 2.8 times more in North Dakota 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· 12th of 51
$141
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.