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 $43.65 Median $67.61 Typical High $177.83 | Facility | None | $43.65 | $67.61 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $50.12 | Professional | None | $43.65 | $43.65 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $47.86 Median $69.18 Typical High $138.04 | Facility | None | $47.86 | $69.18 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $61.66 Typical High $61.66 | Facility | None | $48.98 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Denver HMP Setting Facility Modifier None Typical Low $38.90 Median $43.65 Typical High $63.10 | Facility | None | $38.90 | $43.65 | $63.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $66.07 | Professional | None | $43.65 | $47.86 | $66.07 |
Select Health Setting Facility Modifier None Typical Low $43.65 Median $81.28 Typical High $91.20 | Facility | None | $43.65 | $81.28 | $91.20 |
Select Health Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $63.10 | Professional | None | $43.65 | $43.65 | $63.10 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $44.67 | Professional | None | $42.66 | $42.66 | $44.67 |
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 $21.88 Median $21.88 Typical High $22.91 | Professional | 52 · Reduced service | $21.88 | $21.88 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $9.12 | Professional | 53 · Discontinued | $8.71 | $8.71 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.76 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.57 |
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· 35th of 51
$43.65
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.