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 $54.95 Median $112.20 Typical High $239.88 | Facility | None | $54.95 | $112.20 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $60.26 | Professional | None | $54.95 | $54.95 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $89.13 Typical High $177.83 | Facility | None | $60.26 | $89.13 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $74.13 Typical High $74.13 | Facility | None | $30.90 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Denver HMP Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $79.43 | Facility | None | $54.95 | $54.95 | $79.43 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $81.28 | Professional | None | $54.95 | $60.26 | $81.28 |
Select Health Setting Facility Modifier None Typical Low $54.95 Median $102.33 Typical High $114.82 | Facility | None | $54.95 | $102.33 | $114.82 |
Select Health Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $79.43 | Professional | None | $54.95 | $54.95 | $79.43 |
United Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
United Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | None | $56.23 | $56.23 | $58.88 |
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 $27.54 Median $27.54 Typical High $28.84 | Professional | 52 · Reduced service | $27.54 | $27.54 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | 53 · Discontinued | $10.96 | $10.96 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.51 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.75 |
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· 40th of 51
$54.95
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.