How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $501.19 Typical High $501.19 | Professional | None | $275.42 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $138.04 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $54.95 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $40.74 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $27.54 | $50.12 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,288.25 | Facility | None | $1,148.15 | $1,258.93 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $602.56 | Professional | None | $331.13 | $436.52 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Denver HMP Setting Facility Modifier None Typical Low $389.05 Median $512.86 Typical High $707.95 | Facility | None | $389.05 | $512.86 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $954.99 | Professional | None | $602.56 | $724.44 | $954.99 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $1,096.48 Typical High $1,258.93 | Facility | None | $602.56 | $1,096.48 | $1,258.93 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $812.83 | Professional | None | $524.81 | $524.81 | $812.83 |
United Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
United Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $316.23 | Professional | None | $199.53 | $223.87 | $316.23 |
1 more rate 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $36.31 Median $416.87 Typical High $416.87 | Professional | RR · Rental | $36.31 | $416.87 | $416.87 |
Where Colorado sits
The same service costs 2.8 times more in Montana than in Florida. 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· 27th of 51
$331
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.