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 $331.13 Median $645.65 Typical High $1,380.38 | Facility | None | $331.13 | $645.65 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $346.74 | Professional | None | $331.13 | $331.13 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $346.74 Median $562.34 Typical High $933.25 | Facility | None | $346.74 | $562.34 | $933.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $467.74 Typical High $467.74 | Facility | None | $354.81 | $467.74 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Denver HMP Setting Facility Modifier None Typical Low $331.13 Median $363.08 Typical High $467.74 | Facility | None | $331.13 | $363.08 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $478.63 | Professional | None | $331.13 | $363.08 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $616.60 Typical High $691.83 | Facility | None | $331.13 | $616.60 | $691.83 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $478.63 | Professional | None | $331.13 | $331.13 | $478.63 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $338.84 | Professional | None | $323.59 | $323.59 | $338.84 |
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 $165.96 Median $165.96 Typical High $169.82 | Professional | 52 · Reduced service | $165.96 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $69.18 | Professional | 53 · Discontinued | $66.07 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $51.29 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $34.67 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $34.67 |
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· 45th of 51
$331
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.