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 $33.11 Median $51.29 Typical High $131.83 | Facility | None | $33.11 | $51.29 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $38.02 | Professional | None | $33.11 | $33.11 | $38.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $35.48 Median $56.23 Typical High $93.33 | Facility | None | $35.48 | $56.23 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $46.77 Typical High $46.77 | Facility | None | $33.88 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Denver HMP Setting Facility Modifier None Typical Low $30.90 Median $33.11 Typical High $46.77 | Facility | None | $30.90 | $33.11 | $46.77 |
Kaiser Permanente Setting Professional Modifier None Typical Low $33.11 Median $36.31 Typical High $47.86 | Professional | None | $33.11 | $36.31 | $47.86 |
Select Health Setting Facility Modifier None Typical Low $33.11 Median $60.26 Typical High $69.18 | Facility | None | $33.11 | $60.26 | $69.18 |
Select Health Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $47.86 | Professional | None | $33.11 | $33.11 | $47.86 |
United Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $33.11 | Professional | None | $30.90 | $30.90 | $33.11 |
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 $16.60 Median $16.60 Typical High $16.98 | Professional | 52 · Reduced service | $16.60 | $16.60 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $6.92 | Professional | 53 · Discontinued | $6.61 | $6.61 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $5.13 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.39 |
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· 43rd of 51
$33.11
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.