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 $229.09 Median $446.68 Typical High $933.25 | Facility | None | $229.09 | $446.68 | $933.25 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $234.42 | Professional | None | $229.09 | $229.09 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $389.05 Typical High $645.65 | Facility | None | $239.88 | $389.05 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $323.59 Typical High $323.59 | Facility | None | $239.88 | $323.59 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Denver HMP Setting Facility Modifier None Typical Low $229.09 Median $251.19 Typical High $323.59 | Facility | None | $229.09 | $251.19 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $331.13 | Professional | None | $229.09 | $251.19 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $229.09 Median $416.87 Typical High $478.63 | Facility | None | $229.09 | $416.87 | $478.63 |
Select Health Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $331.13 | Professional | None | $229.09 | $229.09 | $331.13 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
United Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $234.42 | Professional | None | $223.87 | $223.87 | $234.42 |
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 $112.20 Median $112.20 Typical High $117.49 | Professional | 52 · Reduced service | $112.20 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $46.77 | Professional | 53 · Discontinued | $45.71 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $35.48 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $23.44 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $23.44 |
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· 24th of 51
$229
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.