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 $190.55 Median $295.12 Typical High $794.33 | Facility | None | $190.55 | $295.12 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $218.78 | Professional | None | $190.55 | $190.55 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $302.00 Typical High $602.56 | Facility | None | $208.93 | $302.00 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $269.15 Typical High $269.15 | Facility | None | $204.17 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Denver HMP Setting Facility Modifier None Typical Low $169.82 Median $190.55 Typical High $275.42 | Facility | None | $169.82 | $190.55 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $281.84 | Professional | None | $190.55 | $208.93 | $281.84 |
Select Health Setting Facility Modifier None Typical Low $190.55 Median $354.81 Typical High $398.11 | Facility | None | $190.55 | $354.81 | $398.11 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $275.42 | Professional | None | $190.55 | $190.55 | $275.42 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $199.53 | Professional | None | $186.21 | $186.21 | $199.53 |
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 $95.50 Median $95.50 Typical High $100.00 | Professional | 52 · Reduced service | $95.50 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $39.81 | Professional | 53 · Discontinued | $38.02 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $29.51 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.95 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.95 |
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· 46th of 51
$191
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.