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 $144.54 Median $223.87 Typical High $588.84 | Facility | None | $144.54 | $223.87 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $158.49 | Professional | None | $144.54 | $144.54 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $239.88 Typical High $407.38 | Facility | None | $151.36 | $239.88 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $204.17 Typical High $204.17 | Facility | None | $151.36 | $204.17 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Denver HMP Setting Facility Modifier None Typical Low $141.25 Median $144.54 Typical High $204.17 | Facility | None | $141.25 | $144.54 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $208.93 | Professional | None | $144.54 | $158.49 | $208.93 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $263.03 Typical High $302.00 | Facility | None | $144.54 | $263.03 | $302.00 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $208.93 | Professional | None | $144.54 | $144.54 | $208.93 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $144.54 | Professional | None | $138.04 | $138.04 | $144.54 |
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 $72.44 Median $72.44 Typical High $74.13 | Professional | 52 · Reduced service | $72.44 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $30.20 | Professional | 53 · Discontinued | $28.84 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $22.39 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $14.79 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $14.79 |
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· 31st of 51
$145
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.