How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $60.26 Median $93.33 Typical High $239.88 | Facility | None | $60.26 | $93.33 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $69.18 | Professional | None | $60.26 | $60.26 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $64.57 Median $100.00 Typical High $169.82 | Facility | None | $64.57 | $100.00 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $85.11 Typical High $85.11 | Facility | None | $60.26 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Denver HMP Setting Facility Modifier None Typical Low $53.70 Median $60.26 Typical High $87.10 | Facility | None | $53.70 | $60.26 | $87.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $89.13 | Professional | None | $60.26 | $66.07 | $89.13 |
Select Health Setting Facility Modifier None Typical Low $60.26 Median $112.20 Typical High $125.89 | Facility | None | $60.26 | $112.20 | $125.89 |
Select Health Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $87.10 | Professional | None | $60.26 | $60.26 | $87.10 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $60.26 | Professional | None | $56.23 | $56.23 | $60.26 |
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 $30.20 Median $30.20 Typical High $31.62 | Professional | 52 · Reduced service | $30.20 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.59 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $9.33 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.31 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.31 |
Where Colorado sits
Rates are fairly even across states for this service. 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· 20th of 51
$60.26
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.