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 $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $30.90 | Professional | None | $18.62 | $18.62 | $30.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.85 Median $19.05 Typical High $43.65 | Professional | None | $15.85 | $19.05 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Denver HMP Setting Facility Modifier None Typical Low $18.62 Median $28.18 Typical High $48.98 | Facility | None | $18.62 | $28.18 | $48.98 |
Denver HMP Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $58.88 Typical High $85.11 | Professional | None | $43.65 | $58.88 | $85.11 |
Select Health Setting Facility Modifier None Typical Low $43.65 Median $81.28 Typical High $93.33 | Facility | None | $43.65 | $81.28 | $93.33 |
Select Health Setting Professional Modifier None Typical Low $38.90 Median $43.65 Typical High $77.62 | Professional | None | $38.90 | $43.65 | $77.62 |
United Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
5 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 $9.33 Median $9.33 Typical High $15.49 | Professional | 52 · Reduced service | $9.33 | $9.33 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $6.17 | Professional | 53 · Discontinued | $3.72 | $3.72 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $4.68 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $3.09 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $3.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | RR · Rental | $27.54 | $27.54 | $27.54 |
Where Colorado sits
The same service costs 3.2 times more in Hawaii than in Utah. 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· 47th of 51
$18.62
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.